Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
AJNR Am J Neuroradiol. 2011 Mar;32(3):607-11. doi: 10.3174/ajnr.A2399. Epub 2011 Feb 17.
The WEB device is an intrasaccular ellipsoid braided-wire embolization device designed to provide flow disruption along the aneurysm neck. The purpose of this study was to evaluate, in an in vivo aneurysm model, the acute and chronic performance of the WEB device regarding immediacy, degree, and durability of aneurysm occlusion.
The WEB device was implanted in 24 elastase-induced aneurysms in New Zealand white rabbits and followed for 1, 3, 6, and 12 months (n = 6 at all time points). Degree of intra-aneurysmal flow disruption was graded on a 4-point scale based on DSA within 10 minutes following device implantation. Chronic aneurysm occlusion was rated by using a 3-point scale. All aneurysms were harvested for histologic analysis.
Immediate postimplant grade 1 (complete flow cessation) was noted in 7 (29%) of 24 cases. Grade 2 (near-complete flow cessation) was noted in 13 (54%) of 24 cases. At follow-up, complete occlusion was noted in 8 (33%) of 24 cases. Near-complete aneurysm occlusion was noted in 14 (58%) of 24 cases, while incomplete occlusion was noted in 2 (8%) cases. Stable aneurysm occlusion was present in 7 (29%) of 24 cases; progressive occlusion, in 14 (58%); and recanalization, in 3 (13%) cases. Histologic findings included aneurysm cavities filled with organized thrombus with connective tissue across the aneurysm neck.
The WEB device in experimental aneurysms demonstrated promising rates of immediate and long-term aneurysm occlusion.
WEB 装置是一种腔内椭圆形编织丝栓塞装置,旨在沿瘤颈提供血流中断。本研究的目的是在体内动脉瘤模型中评估 WEB 装置在即刻、程度和耐久性方面对动脉瘤闭塞的急性和慢性性能。
WEB 装置被植入 24 个弹性蛋白酶诱导的新西兰白兔动脉瘤中,并随访 1、3、6 和 12 个月(n = 6 在所有时间点)。基于设备植入后 10 分钟内的 DSA,根据动脉瘤内血流中断程度进行 4 分制评分。通过使用 3 分制来评估慢性动脉瘤闭塞。所有动脉瘤均进行组织学分析。
24 例中,7 例(29%)即刻植入后为 1 级(完全血流停止)。24 例中 13 例(54%)为 2 级(接近完全血流停止)。随访时,24 例中完全闭塞 8 例(33%),近完全闭塞 14 例(58%),不完全闭塞 2 例(8%)。24 例中稳定的动脉瘤闭塞 7 例(29%);进行性闭塞 14 例(58%);再通 3 例(13%)。组织学发现包括动脉瘤腔内充满有组织的血栓,连接组织穿过动脉瘤颈部。
WEB 装置在实验性动脉瘤中显示出即刻和长期动脉瘤闭塞的良好效果。