Woven Endobridge Device for Ruptured Aneurysm Within Middle Cerebral Artery Bifurcation
PDF Technical Note

Keywords

Aneurysm
Subarachnoid Hemorrhage
WEB

Categories

How to Cite

Woven Endobridge Device for Ruptured Aneurysm Within Middle Cerebral Artery Bifurcation: Technical Note. (2022). Ictus, 3(2), e09072203011. https://doi.org/10.5281/zenodo.6814159

Abstract

Introduction: Intracranial aneurysms represent an abnormal dilatation on the arterial wall of the cerebral vessels. There is a controversy about the best treatment for ruptured aneurysms located at the middle cerebral artery bifurcation. Case Report: 63-year-old male, presented with left facial paralysis and ipsilateral paresthesia associated with right palpebral ptosis. CT Angiography revealed bleeding in the subarachnoid space, Fisher grade I and the presence of a ruptured, wide neck saccular aneurysm in right middle cerebral artery. Given the size and shape of this wide neck aneurysm (5 mm neck dimension, 7.4 mm height/neck aspect radio and dome/neck radio of 7.43mm.) added to its location, we considered the usage of Woven Endobridge device for endovascular embolization. The device was suitable because of its preferred wide-neck indication (mayor/igual 4mm). Conclusions. Mexico´s experience with intracranial WEB device remains scarce, therefore, pointing out different therapeutic options but neurosurgical clipping highly benefits patients in our country.

PDF Technical Note

References

Toth G, Cerejo R. Intracranial aneurysms: Review of current science and management. Vasc Med [Internet]. 2018;23(3):276–88. Disponible en: http://dx.doi.org/10.1177/1358863X18754693

Pierot L, Spelle L, Cognard C, Szikora I. Wide neck bifurcation aneurysms: what is the optimal endovascular treatment? J Neurointerv Surg [Internet]. 2021 [citado el 27 de abril de 2022];13(5):e9. Disponible en: https://jnis.bmj.com/content/13/5/e9

Procedural complications of endovascular treatment in patients with aneurysmal subarachnoid haemorrhage treated at a single centre. Alanen M, Pyysalo L, Jalava I, et al. Acta Neurochir, 2018;160:551–557. [PubMed] [Google Scholar]

Caroff J, Neki H, Mihalea C, D’Argento F, Abdel Khalek H, Ikka L, et al. Flow-diverter stents for the treatment of saccular middle cerebral artery bifurcation aneurysms. AJNR Am J Neuroradiol [Internet]. 2016;37(2):279–84. Disponible en: http://dx.doi.org/10.3174/ajnr.A4540

De Leacy RA, Fargen KM, Mascitelli JR, et al. Wide-neck bifurcation aneurysms of the middle cerebral artery and basilar apex treated by endovascular techniques: a multicentre, core lab adjudicated study evaluating safety and durability of occlusion (BRANCH). J Neurointerv Surg 2019;11:31–6.

Muskens IS, Senders JT, Dasenbrock HH, et al. The Woven Endobridge device for treatment of intracranial aneurysms: a systematic review. World Neurosurg 2017;98:809–17.

Arthur AS, Molyneux A, Coon AL, Saatci I, Szikora I, Baltacioglu F, et al. The safety and effectiveness of the Woven EndoBridge (WEB) system for the treatment of wide-necked bifurcation aneurysms: final 12-month results of the pivotal WEB Intrasaccular Therapy (WEB-IT) Study. J Neurointerv Surg [Internet]. 2019 [citado el 24 de marzo de 2022];11(9):924–30. Disponible en: https://jnis.bmj.com/content/11/9/924

Karhunen V, Bakker MK, Ruigrok YM, Gill D, Larsson SC. Modifiable risk factors for intracranial aneurysm and aneurysmal subarachnoid hemorrhage: A Mendelian randomization study. J Am Heart Assoc [Internet]. 2021;10(22):e022277. Disponible en: https://www.diva-portal.org/smash/get/diva2:1617103/FULLTEXT01.pdf

Saavedra CR, Rangel CC, Pichardo Uribe OA, Benavides OC, Orijel AP. Reconstrucción endovascular de aneurisma intracraneal mediante dispositivo diversor de flujo Pipeline® Reporte de 2 casos y revisión de la literatura. Rev Fac Med UNAM [Internet]. 2019 [citado el 24 de marzo de 2022];62(3):20–6. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=86939

Zhang X, Tang H, Huang Q, Hong B, Xu Y, Liu J. Total hospital costs and length of stay of endovascular coiling versus neurosurgical clipping for unruptured intracranial aneurysms: Systematic review and meta-analysis. World Neurosurg [Internet]. 2018;115:393–9. Disponible en: http://dx.doi.org/10.1016/j.wneu.2018.04.028

Popielski J, Berlis A, Weber W, Fischer S. Two-center experience in the endovascular treatment of ruptured and unruptured intracranial aneurysms using the WEB device: A retrospective analysis. AJNR Am J Neuroradiol [Internet]. 2018;39(1):111–7. Disponible en: http://dx.doi.org/10.3174/ajnr.a5413

Asnafi S, Rouchaud A, Pierot L, Brinjikji W, Murad MH, Kallmes DF. Efficacy and safety of the Woven EndoBridge (WEB) device for the treatment of intracranial aneurysms: A systematic review and meta-analysis. AJNR Am J Neuroradiol [Internet]. 2016;37(12):2287–92. Disponible en: http://dx.doi.org/10.3174/ajnr.A4900

Pierot L, Cognard C, Anxionnat R, Ricolfi F, CLARITY Investigators. Endovascular treatment of ruptured intracranial aneurysms: factors affecting midterm quality anatomic results: analysis in a prospective, multicenter series of patients (CLARITY). AJNR Am J Neuroradiol [Internet]. 2012;33(8):1475–80. Disponible en: http://dx.doi.org/10.3174/ajnr.A3003

Goyal N, Hoit D, DiNitto J, Elijovich L, Fiorella D, Pierot L, et al. How to WEB: a practical review of methodology for the use of the Woven EndoBridge. J Neurointerv Surg [Internet]. 2020 [citado el 25 de marzo de 2022];12(5):512–20. Disponible en: https://jnis.bmj.com/content/12/5/512

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2022 Ictus