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Multicenter Study
. 2014 Nov-Dec;35(11):2106-11.
doi: 10.3174/ajnr.A4028. Epub 2014 Jul 3.

WEB intrasaccular flow disruptor-prospective, multicenter experience in 83 patients with 85 aneurysms

C Papagiannaki  1 , L Spelle  2 , A-C Januel  3 , A Benaissa  4 , J-Y Gauvrit  5 , V Costalat  6 , H Desal  7 , F Turjman  8 , S Velasco  9 , X Barreau  10 , P Courtheoux  11 , C Cognard  3 , D Herbreteau  1 , J Moret  2 , L Pierot  12
Affiliations
Multicenter Study

WEB intrasaccular flow disruptor-prospective, multicenter experience in 83 patients with 85 aneurysms

C Papagiannaki et al. AJNR Am J Neuroradiol. 2014 Nov-Dec.

Abstract

Background and purpose: The safety and efficacy of WEB flow disruption have been analyzed in small, retrospective series. The object of this study was to evaluate the safety and efficacy of WEB flow disruption in a large, multicenter, prospectively collected population.

Materials and methods: Data from all patients treated with the WEB-DL device between June 2011 and October 2013 in 11 French neurointerventional centers were prospectively collected and retrospectively analyzed. Complications occurring during and after treatment were analyzed as well as morbidity and mortality at 1 month. Aneurysm occlusion status at the last follow-up was analyzed.

Results: Eighty-three patients with 85 aneurysms were included in this series. Technical success was achieved in 77 patients with 79 aneurysms (92.9%). Periprocedural complications were observed in 9 patients (10.8%), leading to permanent neurologic deficits in 3 (3.9%). Morbidity and mortality at 1 month were 1.3% and 0.0%, respectively. Angiographic follow-up was performed for 65/79 aneurysms (82.3%) 3-24 months after treatment (mean, 5.3 months). Complete aneurysm occlusion was observed in 37/65 aneurysms (56.9%); neck remnant, in 23/65 (35.4%); and aneurysm remnant, in 5/65 (7.7%).

Conclusions: In this large prospective series of patients, WEB flow disruption was a safe and efficient technique.

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Figures

Fig 1.
Fig 1.
Anterior communicating artery unruptured aneurysm with a wide neck, before (A) and immediately after (B) WEB deployment.
Fig 2.
Fig 2.
Middle cerebral bifurcation wide-neck unruptured aneurysm before (A) and immediately after (B) WEB deployment. Eight-month follow-up DSA, working projection (C) and frontal projection (D).
Fig 3.
Fig 3.
Failure to deploy the WEB due to the tortuous vessel anatomy. A, Unruptured AcomA aneurysm. B, WEB-DL (arrow on the second of 3 marker bands) could not be advanced through a tortuous turn by using only the delivery catheter. C, WEB-DL could not be advanced through the tortuous turn with intermediate catheter support of the delivery catheter (arrow shows the proximal marker of the WEB). D, Final result after balloon-assisted coiling of the aneurysm.
See this image and copyright information in PMC

References

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