Lukas Goertz1, Thomas Liebig2, Eberhard Siebert3, Moriz Herzberg2, Jan Borggrefe4, Thorsten Lichtenstein4, Franziska Dorn2, Christoph Kabbasch4. 1. Department of Neuroradiology, University Hospital of Cologne, Cologne, Germany; Center for Neurosurgery, University Hospital of Cologne, Cologne, Germany. Electronic address: lukas.goertz@uk-koeln.de. 2. Department of Neuroradiology, University Hospital Munich (LMU), Munich, Germany. 3. Department of Neuroradiology, University Hospital of Berlin (Charité), Berlin, Germany. 4. Department of Neuroradiology, University Hospital of Cologne, Cologne, Germany.
Abstract
OBJECTIVE: Woven Endobridge (WEB) embolization is an approved technique for endovascular treatment of wide-necked and bifurcation aneurysms. However, the WEB has not yet been routinely used for internal carotid artery (ICA) sidewall aneurysms. In this multicenter study, we evaluate the safety and efficacy of WEB for treatment of these aneurysms. METHODS: We reviewed all patients with ICA sidewall aneurysms who were treated with WEB at 3 German neurovascular centers between 2011 and 2018. Technical success, complication rates, and angiographic outcome were retrospectively assessed. RESULTS: Twenty patients (mean age, 56.3 ± 13.0 years) with 20 ICA aneurysms (6 ruptured) were identified. The aneurysms were located at the paraophthalmic segment (n = 10), the posterior communicating artery segment (n = 9), and the anterior choroidal artery segment (n = 1). The mean aneurysm size was 8.1 ± 5.2 mm and 60% were wide-necked. The aneurysms were treated with a single WEB (n = 11) or in combination with coiling and/or stent implantation (n = 7). WEB implantation failed in 2 aneurysms because of a sharp aneurysm angle. There were 1 periprocedural thromboembolic event and 1 in-stent stenosis at follow-up, which remained asymptomatic in both cases. There was no procedure-related morbidity and mortality. At follow-up, complete occlusion was achieved in 76.5%, neck remnants in 17.6%, and aneurysms remnants in 5.9%. CONCLUSIONS: The WEB device can be used for treatment of ICA sidewall aneurysms with a high level of procedural safety and a high degree of technical success.
OBJECTIVE: Woven Endobridge (WEB) embolization is an approved technique for endovascular treatment of wide-necked and bifurcation aneurysms. However, the WEB has not yet been routinely used for internal carotid artery (ICA) sidewall aneurysms. In this multicenter study, we evaluate the safety and efficacy of WEB for treatment of these aneurysms. METHODS: We reviewed all patients with ICA sidewall aneurysms who were treated with WEB at 3 German neurovascular centers between 2011 and 2018. Technical success, complication rates, and angiographic outcome were retrospectively assessed. RESULTS: Twenty patients (mean age, 56.3 ± 13.0 years) with 20 ICA aneurysms (6 ruptured) were identified. The aneurysms were located at the paraophthalmic segment (n = 10), the posterior communicating artery segment (n = 9), and the anterior choroidal artery segment (n = 1). The mean aneurysm size was 8.1 ± 5.2 mm and 60% were wide-necked. The aneurysms were treated with a single WEB (n = 11) or in combination with coiling and/or stent implantation (n = 7). WEB implantation failed in 2 aneurysms because of a sharp aneurysm angle. There were 1 periprocedural thromboembolic event and 1 in-stent stenosis at follow-up, which remained asymptomatic in both cases. There was no procedure-related morbidity and mortality. At follow-up, complete occlusion was achieved in 76.5%, neck remnants in 17.6%, and aneurysms remnants in 5.9%. CONCLUSIONS: The WEB device can be used for treatment of ICA sidewall aneurysms with a high level of procedural safety and a high degree of technical success.
Authors: Jean Raymond; Anne-Christine Januel; Daniela Iancu; Daniel Roy; Alain Weill; Andrew Carlson; Tim E Darsaut Journal: Interv Neuroradiol Date: 2019-11-05 Impact factor: 1.610
Authors: L Goertz; T Liebig; E Siebert; M Herzberg; L Pennig; M Schlamann; J Borggrefe; B Krischek; F Dorn; C Kabbasch Journal: AJNR Am J Neuroradiol Date: 2019-09-05 Impact factor: 3.825
Authors: L Goertz; T Liebig; E Siebert; Y Özpeynirci; L Pennig; E Celik; M Schlamann; F Dorn; C Kabbasch Journal: AJNR Am J Neuroradiol Date: 2022-07-21 Impact factor: 4.966
Authors: Jessica K Campos; Barry Cheaney Ii; Brian V Lien; David A Zarrin; Chau D Vo; Geoffrey P Colby; Li-Mei Lin; Alexander L Coon Journal: Stroke Vasc Neurol Date: 2020-03-25