Aims and objectives
Aim of our single center study was to retrospectively evaluate all patients treated for intracranial aneurysms with intrasaccular disruptor device "WEB SL".
We reported clinical and radiological follow-up up to one year from treatment.
Methods and materials
We retrospectively evaluated 16 patients,
14 of which were treated in emergency settings aftersubarachnoid haemorrhage due to aneurysm rupture.
All patients were evaluated pre-operatively with CT and CTA to analyze the dome-neck ratio and feasibility for the endovascular procedure.
During Digital Subtracted Angiography (DSA) we performed 3D-XA in all patients to better estimate shape and size of the aneurysm andselect the appropriate "WEB SL" device.
Exclusion criteria were a dome-neck ration >1.6 which led to a different endovascular approach (coiling) or aneurysm size >1 cm...
Out of the 16 treatedpatients,
no failure of deployment were witnessed,
while in four patients (25%) it was required to change the size of the first deployed WEB SL.
Average neck size was 3.6 mm (range 2.2-5.5 mm),
while average dome size was 5.1 mm (range 2.5-8 mm).
We registered only one procedural complication (6%) due to distal embolization during catheterization of the vessel which led to frontal ischemia with persistent disability at discharge (mRS: 4).
In the 12 patients that underwent radiological follow-up,
WEB SL device is a promising alternative to other endovascular approaches in patients with wide necked and bifurcation aneurysms; it appeared feasible in patient with acute aneurysm rupture where pre-treatment with antiplatelet drugs for stent deployment is contraindicated.
In our small experience treatment appeared to be safe and effective,
with low rate of complications and no rebleeding in the short-medium period.
In our case series,
a non-negligible percentage of patients (25%),
required the opening of a second device,
due to an incorrect first sizing of...
al; WEB-DL Endovascular Treatment of Wide-Neck Bifurcation Aneurysms: Short- and Midterm Results in a European Study;American Journal of NeuroradiologyMar 2014,35(3)432-438
2.Caroff J,et al;Occlusion assessment of intracranial aneurysms treated with the WEB device.Neuroradiology.2016 Sep;58(9):887-91.
et al;WEB treatment of intracranial aneurysms: feasibility,
and 1-month safety results with the WEB DL and WEB SL/SLS in the French observatory.
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