Department of Interventional Neuroradiology, Neuro Brain Vascular Center, Hopital Bicetre, APHP, Paris Sud Université, Paris, France.
Department of Neurosurgery, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.
J Neurointerv Surg. 2019 Apr;11(4):386-389. doi: 10.1136/neurintsurg-2018-014104. Epub 2018 Oct 5.
Woven EndoBridge (WEB) deployment remains challenging in aneurysms with a complex shape or orientation.
To show that embolization of wide-neck bifurcation aneurysms using the WEB device balloon remodeling-assisted technique is a feasible and elegant endovascular solution compared with other techniques, such as balloon remodeling or stent-assisted coiling.
10 cases (10 aneurysms in 9 patients) of balloon remodeling-assisted WEB treatment of unruptured complex bifurcation aneurysms were treated in our institution and retrospectively analyzed. Details of clinical presentations, technical details, perioperative and postoperative complications, and outcomes were collected. Immediate and long-term angiographic results were also evaluated.
Aneurysms included six middle cerebral artery aneurysms, one anterior communicating artery aneurysm, one posterior communicating artery aneurysm, one basilar artery aneurysm, and one T-shaped carotid aneurysm. Mean dome width was 6.55 mm, mean neck size 4.5 mm, mean height 4.79 mm, and mean dome-to-neck ratio was 1:1.46. Treatment was performed exclusively with the balloon remodeling-assisted WEB technique in all cases. The device was successfully deployed in every case. Periprocedural thromboembolic or hemorrhagic events did not occur. The modified Rankin Scale score at discharge was 0 for all patients. At mid-term or long-term angiographic follow-up, adequate occlusion was observed in 7 aneurysms from 8 controlled cases (87.5%), and one patient (2 aneurysms) did not have angiographic follow-up.
The balloon remodeling-assisted WEB technique seems to be a safe and effective solution for endovascular treatment of unruptured wide-neck bifurcation aneurysms with specific complex anatomy. However, further studies are needed to evaluate the rate of complications and long-term efficacy.
编织式 EndoBridge（WEB）在形状或朝向复杂的动脉瘤中进行部署仍然具有挑战性。
与球囊重塑或支架辅助弹簧圈等其他技术相比，展示 WEB 装置球囊重塑辅助技术栓塞宽颈分叉动脉瘤是一种可行且优雅的血管内解决方案。
在我们机构治疗了 10 例（9 例患者的 10 个动脉瘤）未破裂复杂分叉动脉瘤的 WEB 治疗中采用球囊重塑辅助技术，并对其进行了回顾性分析。收集了临床表现、技术细节、围手术期和术后并发症以及结果的详细信息。还评估了即刻和长期血管造影结果。
动脉瘤包括 6 个大脑中动脉动脉瘤、1 个前交通动脉瘤、1 个后交通动脉瘤、1 个基底动脉动脉瘤和 1 个 T 形颈动脉动脉瘤。平均瘤顶宽度为 6.55mm，平均颈宽 4.5mm，平均瘤高 4.79mm，平均瘤颈比为 1:1.46。所有病例均采用球囊重塑辅助 WEB 技术进行治疗。该装置在所有病例中均成功部署。围手术期无血栓栓塞或出血事件发生。所有患者出院时改良 Rankin 量表评分为 0。在中期或长期血管造影随访中，8 例可控制病例中有 7 例（87.5%）观察到充分闭塞，1 例（2 个动脉瘤）无血管造影随访。
球囊重塑辅助 WEB 技术似乎是一种安全有效的治疗方法，适用于特定复杂解剖结构的未破裂宽颈分叉动脉瘤的血管内治疗。然而，需要进一步的研究来评估并发症的发生率和长期疗效。
