8. Woven EndoBridge system for wide-necked bifurcation aneurysms treatment: Preliminary results of the first center in Southeast Asia
Nội dung chính của bài viết
This study reports the initial results of wide-necked bifurcation aneurysms treated with Woven EndoBridge (WEB) system at one of the first centers in Southeast Asia from April 2019 to June 2022. A total of 12 patients (50% female, median age of 66) with 12 aneurysms (9 unruptured and 3 ruptured) were recruited. The aneurysms were located in the basilar apex (4 patients), anterior communicating artery (4 patients), middle cerebral artery (3 patients), and posterior cerebral artery (1 patient). The average aneurysm size was 6.3mm (range 4.8 - 8.0mm) with mean dome to neck ratio of 1.2 and mean neck size of 5.4 mm (range 3.7 - 6.9mm). The technique was successful in all cases (100%) without any adjunctive devices. No intraoperative rupture occurred. Thromboembolic complications that occurred in two patients resulted in death in 1 patient (accompanied by retroperitoneal bleeding) (1/12, 8.3%) and moderate disability in 1 patient (1/12, 8.3%). The MRI follow-up at 3 months showed complete occlusion in 6 aneurysms (6/11, 54.5%) and neck remnant in 5 aneurysms (5/11, 45.5%). The study demonstrated that the WEB system alone was feasible to treat both ruptured and unruptured wide-necked bifurcation aneurysms. This device seems to be a promising tool for the treatment of complex wide-necked bifurcation aneurysms.
Chi tiết bài viết
Woven EndoBridge system, cerebral aneurysm, wide-necked bifurcation aneurysm
Tài liệu tham khảo
2. Fiorella D, Arthur AS, Chiacchierini R, et al. How safe and effective are existing treatments for wide-necked bifurcation aneurysms? Literature-based objective performance criteria for safety and effectiveness. Journal of NeuroInterventional Surgery. 2017;9(12):1197- 201.
3. Molyneux A, Kerr R, Yu LM, et al. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomized trial. Journal of stroke and cerebrovascular diseases. 2002;11(6):304-14.
4. Wiebers DO, Whisnant JP, Huston J III, et al. International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet. 2003;362:103- 110.
5. Pierot L, Spelle L, Cognard C, et al. Wide neck bifurcation aneurysms: what is the optimal endovascular treatment? Journal of NeuroInterventional Surgery. 2021;13(5):e9.
6. Pierot L, Moret J, Barreau X, et al. Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series. Journal of Neurointerventional surgery. 2018;10(6):553-9.
7. Arthur AS, Molyneux A, Coon AL, 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. Journal of neurointerventional surgery. 2019 Sep 1;11(9):924-30.
8. Lubicz B, Klisch J, Gauvrit JY, et al. WEB-DL endovascular treatment of wide-neck bifurcation aneurysms: short- and midterm results in a European study. AJNR Am J Neuroradiol. 2014; 35:432–38 10.3174/ajnr. A3869.
9. Tran Anh Tuan, Pham Minh Thong. Study on the treatment of wide-neck cerebral aneurysms by endovascular intervention. PhD thesis of Hanoi Medical University 2014.
10. Goyal N, Hoit D, DiNitto J, et al. How to WEB: a practical review of methodology for the use of the Woven EndoBridge. Journal of neurointerventional surgery. 2020;12(5):512-20.
11. Cagnazzo F, Marnat G, Ferreira I, et al. Comparison of Woven EndoBridge device sizing with conventional measurements and virtual simulation using the Sim&Size software: a multicenter experience. Journal of NeuroInterventional Surgery. 2021;13(10):924-9.
12. Van Rooij SB, Sprengers ME, Peluso JP, et al. A systematic review and meta-analysis of Woven EndoBridge single layer for treatment of intracranial aneurysms. Interventional Neuroradiology. 2020;26(4):455-60.