One-Year Angiographic Follow-Up after WEB-SL Endovascular Treatment of Wide-Neck Bifurcation Intracranial Aneurysms

• DOI: 10.3174/ajnr.a4457
• Publication Date: 2015-08-20T22:44:13Z
• Authors: R. Sivan-Hoffmann; B. Gory; R. Riva; P.-E. Labeyrie; F. Signorelli; I. Eldesouky; U. Gonike-Sadeh; X. Armoiry; F. Turjman
• Keywords: Male; recurrent disease; Wide-Neck; [SPI.MAT] Engineering Sciences [physics]/Materials; [SPI.MAT]Engineering Sciences [physics]/Materials; endovascular aneurysm repair; wide neck intracranial aneurysm; 0302 clinical medicine; Recurrence; Prospective Studies; clinical article; neurovascular embolization device; Endovascular Procedures; Middle Aged; Embolization, Therapeutic; 3. Good health; aged; Treatment Outcome; brain angiography; Female; Therapeutic; devices; radiography; prospective study; Adult; artificial embolization; anterior communicating artery; Endovascular Treatment; digital subtraction angiography; Article; Embolization; 03 medical and health sciences; follow up; Humans; human; procedures; middle cerebral artery; Intracranial Aneurysm; acetylsalicylic acid; thromboembolism; WEB-SL; compression; Intracranial Aneurysms; Cerebral Angiography; endovascular surgery; adverse effects; stent; Follow-Up Studies

Endovascular coiling of wide-neck intracranial aneurysms is associated with low rates of initial angiographic occlusion and high rates of recurrence. The WEB intrasaccular device has been developed specifically for this indication. To date, there has been no report of the long-term follow-up of a series of patients with aneurysms treated with this type of device, to our knowledge. Our aim was to evaluate a 1-year follow-up of angiographic results in a prospective single-center series of patients treated with the WEB-Single-Layer (SL) device.All patients treated with the WEB-SL device in our center between August 2013 and May 2014 were prospectively included. One-year angiographic outcomes were assessed. Results at follow-up were graded as complete occlusion, neck remnant, or residual aneurysm.Eight patients with 8 unruptured wide-neck aneurysms were enrolled in this study. Average dome width was 7.5 mm (range, 5.4-10.7 mm), and average neck size was 4.9 mm (range, 2.6-6.5 mm). One-year angiographic follow-up obtained in all aneurysms included 1 complete aneurysm occlusion (12.5%), 6 neck remnants (75%), and 1 aneurysm remnant (12.5%). Of 8 aneurysms, worsening of aneurysm occlusion was observed in 2 (25%) by compression of the WEB device. There was no angiographic recurrence of initially totally occluded aneurysms. No bleeding was observed during the follow-up period.Endovascular therapy of intracranial aneurysms with the WEB-SL device allows treatment of wide-neck aneurysms with a high rate of neck remnant at 1 year, at least partially explained by WEB compression. Initial size selection and technologic improvements could be an option for optimization of aneurysm occlusion in WEB-SL treatment.