BACKGROUND: The endovascular treatment of middle cerebral artery (MCA) aneurysms with unfavorable anatomy (wide neck, unfavorable morphology) is frequently challenging. Flow disruption with the WEB is a potentially interesting endovascular treatment for this type of aneurysm. OBJECTIVE: To report in a multicenter series the preliminary treatment experience of MCA aneurysms with flow disruption by the WEB. METHODS: Thirty-three patients with 34 MCA aneurysms were treated with the WEB in 5 European centers. The ability to successfully deploy the WEB, procedure- and device-related adverse events, morbidity and mortality of the treatment, and short-term angiographic follow-up results were analyzed. RESULTS: Most treated aneurysms were unruptured (85.3%) and were between 5 and 10 mm (85.3%) with a neck size ≥ 4 mm (88.2%). The treatment failed in 1 of the 34 aneurysms (2.9%) owing to a lack of appropriate device size. Treatment was performed exclusively with the WEB in 29 of 33 aneurysms (87.9%). Additional treatment (coiling and/or stenting) was used in 4 of 33 aneurysms (12.1%). Mortality of the treatment was 0.0% and morbidity was 3.1% (intraoperative rupture with modified Rankin Scale score of 3 at the 1-month follow-up). In short-term follow-up (range, 2-12 months), adequate occlusion (total occlusion or neck remnant) was observed in 83.3% of aneurysms. CONCLUSION: WEB flow disruption seems to be a promising technique for the treatment of complex MCA aneurysms, particularly those with a wide neck or unfavorable dome-to-neck ratio.
BACKGROUND: The endovascular treatment of middle cerebral artery (MCA) aneurysms with unfavorable anatomy (wide neck, unfavorable morphology) is frequently challenging. Flow disruption with the WEB is a potentially interesting endovascular treatment for this type of aneurysm. OBJECTIVE: To report in a multicenter series the preliminary treatment experience of MCA aneurysms with flow disruption by the WEB. METHODS: Thirty-three patients with 34 MCA aneurysms were treated with the WEB in 5 European centers. The ability to successfully deploy the WEB, procedure- and device-related adverse events, morbidity and mortality of the treatment, and short-term angiographic follow-up results were analyzed. RESULTS: Most treated aneurysms were unruptured (85.3%) and were between 5 and 10 mm (85.3%) with a neck size ≥ 4 mm (88.2%). The treatment failed in 1 of the 34 aneurysms (2.9%) owing to a lack of appropriate device size. Treatment was performed exclusively with the WEB in 29 of 33 aneurysms (87.9%). Additional treatment (coiling and/or stenting) was used in 4 of 33 aneurysms (12.1%). Mortality of the treatment was 0.0% and morbidity was 3.1% (intraoperative rupture with modified Rankin Scale score of 3 at the 1-month follow-up). In short-term follow-up (range, 2-12 months), adequate occlusion (total occlusion or neck remnant) was observed in 83.3% of aneurysms. CONCLUSION: WEB flow disruption seems to be a promising technique for the treatment of complex MCA aneurysms, particularly those with a wide neck or unfavorable dome-to-neck ratio.
Authors: J Caroff; C Mihalea; J Klisch; C Strasilla; A Berlis; T Patankar; W Weber; D Behme; E A Jacobsen; T Liebig; S Prothmann; C Cognard; T Finkenzeller; J Moret; L Spelle Journal: AJNR Am J Neuroradiol Date: 2015-07-09 Impact factor: 3.825
Authors: B Lubicz; J Klisch; J-Y Gauvrit; I Szikora; M Leonardi; T Liebig; N P Nuzzi; E Boccardi; F D Paola; M Holtmannspötter; W Weber; E Calgliari; V Sychra; B Mine; L Pierot Journal: AJNR Am J Neuroradiol Date: 2014-01-23 Impact factor: 3.825
Authors: C Papagiannaki; L Spelle; A-C Januel; A Benaissa; J-Y Gauvrit; V Costalat; H Desal; F Turjman; S Velasco; X Barreau; P Courtheoux; C Cognard; D Herbreteau; J Moret; L Pierot Journal: AJNR Am J Neuroradiol Date: 2014-07-03 Impact factor: 3.825
Authors: L Pierot; J Moret; F Turjman; D Herbreteau; H Raoult; X Barreau; S Velasco; H Desal; A-C Januel; P Courtheoux; J-Y Gauvrit; C Cognard; A Molyneux; J Byrne; L Spelle Journal: AJNR Am J Neuroradiol Date: 2015-10-29 Impact factor: 3.825
Authors: R Sivan-Hoffmann; B Gory; R Riva; P-E Labeyrie; F Signorelli; I Eldesouky; U Gonike-Sadeh; X Armoiry; F Turjman Journal: AJNR Am J Neuroradiol Date: 2015-08-20 Impact factor: 3.825
Authors: J Caroff; C Mihalea; H Neki; D Ruijters; L Ikka; N Benachour; J Moret; L Spelle Journal: AJNR Am J Neuroradiol Date: 2014-02-13 Impact factor: 3.825