Department of Interventional Neuroradiology Neuro Brain Vascular Center, Hopital Bicetre, APHP, Paris Sud Université, Le Kremlin-Bicetre, Île-de-France, France.
Department of Neurosurgery, University of Medicine and Pharmacy 'Victor Babes', Timisoara, Romania.
J Neurointerv Surg. 2019 May;11(5):511-515. doi: 10.1136/neurintsurg-2018-014343. Epub 2019 Jan 17.
The treatment of wide neck bifurcation aneurysms remains challenging despite the introduction of new techniques (Y stenting, waffle cone technique, or flow diverter stents). The Woven EndoBridge (WEB) device is an innovative solution for this type of cerebral aneurysm. A new WEB 17 is now available and has been designed to offer smaller sized devices to optimize navigability and delivery.
Between February 2017 and April 2018 all patients treated with the WEB 17 device in our center were retrospectively reviewed. 25 patients with 28 non-ruptured aneurysms were identified and analyzed. Three patients with two aneurysms both treated with the WEB device were identified.
The device was successfully deployed in all cases. Procedure related morbidity was 4% and mortality was 0%. In one case, a delayed postprocedural thromboembolic event occurred owing to device protrusion. Technical success, complications, angiographic outcomes, procedural data, and follow-ups are reported. The modified Rankin Scale score at discharge was 0 for 24 patients (96%). At the 3, 6, or 9 month follow-up, angiograms were taken of 21 of the 25 patients (84%) (24 of 28 aneurysms had been controlled); 3 patients (3 aneurysms) did not receive angiographic follow-up at the time of submission of this work. Complete occlusion was achieved in 22 of 24 aneurysms (91.66%), and 2 of 24 aneurysm (8.33%) showed a neck remnant.
The WEB 17 is safe and technically feasible, according to this retrospective single center analysis. For very small bifurcation aneurysms, the WEB 17 seems to have lower complication rates than stent assisted techniques. However, further studies are needed to evaluate the complication rate and long term efficiency.
尽管新技术（Y 支架、华夫锥技术或血流导向支架）的出现，宽颈分叉动脉瘤的治疗仍然具有挑战性。Woven EndoBridge（WEB）装置是治疗这种类型脑动脉瘤的创新解决方案。一种新型的 WEB 17 现已推出，旨在提供更小尺寸的设备，以优化可操作性和输送。
回顾性分析 2017 年 2 月至 2018 年 4 月期间在我院接受 WEB 17 装置治疗的所有患者。共发现并分析了 25 例 28 例未破裂动脉瘤患者。发现 3 例患者有两个动脉瘤，均接受 WEB 装置治疗。
所有病例均成功植入装置。与手术相关的发病率为 4%，死亡率为 0%。1 例患者因装置突出发生迟发性术后血栓栓塞事件。报告了技术成功率、并发症、血管造影结果、手术数据和随访情况。24 例患者（96%）出院时改良 Rankin 量表评分为 0。在 3、6 或 9 个月的随访中，对 25 例患者中的 21 例（84%）进行了血管造影随访（28 个动脉瘤中有 24 个得到控制）；在提交本报告时，有 3 例患者（3 个动脉瘤）未进行血管造影随访。24 个动脉瘤中有 22 个（91.66%）达到完全闭塞，24 个动脉瘤中有 2 个（8.33%）显示残余瘤颈。
根据这项回顾性单中心分析，WEB 17 是安全且技术可行的。对于非常小的分叉动脉瘤，WEB 17 的并发症发生率似乎低于支架辅助技术。然而，需要进一步的研究来评估并发症发生率和长期疗效。
