Kevin Janot1, Denis Herbreteau2, Aymeric Amelot3, Guillaume Charbonnier4, Fakhreddine Boustia2, Ana Paula Narata2, Basile Kerleroux2, Richard Bibi2, Chrysanthi Papagiannaki5, Aymeric Rouchaud6, Laurent Pierot7. 1. University Hospital of Tours, Neuroradiology Department, 2, boulevard Tonnellé, 37000 Tours, France. Electronic address: kevin.janot@hotmail.com. 2. University Hospital of Tours, Neuroradiology Department, 2, boulevard Tonnellé, 37000 Tours, France. 3. University Hospital of La Pitié-Salpétrière, Neurosurgery Department, 47-83, boulevard de l'hopital, 75013 Paris, France. 4. University Hospital of Besançon, Neuroradiology Department, 3, boulevard Alexandre-Fleming, 25000 Besançon, France. 5. University Hospital of Rouen, Neuroradiology Department, 37, boulevard Gambetta, 76000 Rouen, France. 6. University Hospital of Limoges, Neuroradiology Department, 2, avenue Martin Luther King, 87000 Limoges, France. 7. University Hospital of Reims, Neuroradiology Department, 45, rue Cognacq-Jay, 51100 Reims, France.
Abstract
BACKGROUND AND PURPOSE: Web shape modification (WSM) has previously been associated with aneurysm recurrence. We report here our five-year experience of WEB device use with a quantitative approach of the WSM phenomenon. METHODS: From July 2012 to July 2017, 50 patients with 51 unruptured aneurysms treated with the WEB device have been prospectively enrolled in our data base and retrospectively analyzed. An independent "core lab" evaluated anatomical results and potential WSM in DSA follow-up. We defined the WSM ratio (WSMr) as a relative index between the height and the width of the device in working projections which gave an evaluation of the device deformation over the time. RESULTS: During the total follow-up period, WSM was observed in 35/48 aneurysms (72.9%). Adequate occlusion rates were 87.0% and 92.6% with and without WSM respectively (P = 0.65). 30 out the 35 (85.7%) shape modifications were already noticed at short-term follow-up (6-month DSA). 33 patients had 2 DSA controls and WSMr measurements were available in 24 patients: 18 (75%) with WSM and 6 (25%) without WSM. In the group with WSM, WSMr values were 0.80 in post-embolization, 0.52 at the first DSA angiogram and 0.42 at the second DSA angiogram. CONCLUSION: WEB shape modification was observed in more than half of cases but with no influence regarding adequate occlusion rate. This quantitative approach of WSM highlights that this phenomenon appears to be early and progressive over time. This supports the hypothesis that WSM could be more probably related to aneurysm healing rather than external compression.
BACKGROUND AND PURPOSE: Web shape modification (WSM) has previously been associated with aneurysm recurrence. We report here our five-year experience of WEB device use with a quantitative approach of the WSM phenomenon. METHODS: From July 2012 to July 2017, 50 patients with 51 unruptured aneurysms treated with the WEB device have been prospectively enrolled in our data base and retrospectively analyzed. An independent "core lab" evaluated anatomical results and potential WSM in DSA follow-up. We defined the WSM ratio (WSMr) as a relative index between the height and the width of the device in working projections which gave an evaluation of the device deformation over the time. RESULTS: During the total follow-up period, WSM was observed in 35/48 aneurysms (72.9%). Adequate occlusion rates were 87.0% and 92.6% with and without WSM respectively (P = 0.65). 30 out the 35 (85.7%) shape modifications were already noticed at short-term follow-up (6-month DSA). 33 patients had 2 DSA controls and WSMr measurements were available in 24 patients: 18 (75%) with WSM and 6 (25%) without WSM. In the group with WSM, WSMr values were 0.80 in post-embolization, 0.52 at the first DSA angiogram and 0.42 at the second DSA angiogram. CONCLUSION: WEB shape modification was observed in more than half of cases but with no influence regarding adequate occlusion rate. This quantitative approach of WSM highlights that this phenomenon appears to be early and progressive over time. This supports the hypothesis that WSM could be more probably related to aneurysm healing rather than external compression.