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The outcomes of recurrent wide-necked intracranial aneurysms treated with the Woven EndoBridge (WEB): A retrospective bicenter study - 08/06/21

Doi : 10.1016/j.neurad.2021.05.008 
Kemal Alpay a, , Alberto Nania b, Riitta Parkkola c, Jonathan Downer b, Antti Lindgren d, e, f, Riitta Rautio a
a Department of Radiology, Turku University Hospital, Turku, Finland 
b Department of Clinical Neurosciences, Western General Hospital, Edinburgh, United Kingdom 
c Department of Radiology, Turku University Hospital and Turku University, Turku, Finland 
d Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland 
e Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland 
f Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland 

Corresponding author at: TYKS T-hospital, E Wing, 4th floor, Hämeentie 11, PO Box 52, 20521, Turku, Finland.TYKS T-hospitalE Wing4th floorHämeentie 11PO Box 52Turku20521Finland
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 08 June 2021

Graphical abstract




Le texte complet de cet article est disponible en PDF.

Highlights

This study reports results of the largest cohort with the longest median follow-up of radiological outcomes of wide-necked recurrent intracranial aneurysms treated with the Woven EndoBridge.
The rate of adequate radiological outcomes of wide-necked recurrent intracranial aneurysms treated with the Woven EndoBridge is 87%.
The Woven EndoBridge could be an effective treatment for challenging recurrent intracranial aneurysms.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

The Woven EndoBridge (WEB) is a device for the treatment of intracranial wide-necked bifurcation aneurysms. The safety and effectiveness of WEB for intracranial aneurysms have both been evaluated in previous trials. Our aim was to study the outcomes of recurrent intracranial aneurysms (IAs) treated with WEB.

Methods

Clinical and radiological outcomes of patients with a wide-necked aneurysm recurrence, which was treated with WEB device, were assessed. Imaging follow-up was performed with digital subtraction angiography and/or magnetic resonance angiography. Aneurysm occlusion was determined using by the Raymond-Roy Occlusion Classification (RROC). RROC 1 and RROC 2 were considered as adequate radiological outcome.

Results

Twenty-two patients with 23 recurrent IAs were treated with WEB. Of which, 17 of recurrent IAs (74%) previously treated by coiling, three (13%) by clipping and three (13%) by WEB. The most common location of the recurrent IA was the middle cerebral artery (n = 10, 43%). Endovascular treatment with WEB alone was suitable for 20 recurrent IAs (87%). Ancillary devices were also used: coils in two (9%), and a stent in one (4%). Radiological follow-up results available for all patients (range: 3–60 months; median 24 months). Adequate occlusion (RROC I and II) was achieved in 20 recurrent IAs (87%). A hemorrhagic complication occurred 2 weeks post treatment in one patient (5%).

Conclusions

WEB could be an effective treatment with low rates of complications for challenging cases of recurrent wide-necked IAs.

Le texte complet de cet article est disponible en PDF.

Abbreviations : IA, EVT, RROC

Keywords : WEB, Aneurysm, Endovascular treatment, Recurrence


Plan


 Some results of the study were presented at ESMINT congress on 4th of September 2019 in a plenary session.


© 2021  The Author(s). Publié par Elsevier Masson SAS. Tous droits réservés.
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