University Hospital of Tours, Neuroradiology Department, 2, boulevard Tonnellé, 37000 Tours, France.
University Hospital of Tours, Neuroradiology Department, 2, boulevard Tonnellé, 37000 Tours, France.
J Neuroradiol. 2020 May;47(3):193-196. doi: 10.1016/j.neurad.2019.02.010. Epub 2019 Mar 7.
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.
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.
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.
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.
Web 形状修改（WSM）先前与动脉瘤复发有关。我们在此报告我们使用 WEB 装置的五年经验，采用 WSM 现象的定量方法。
从 2012 年 7 月至 2017 年 7 月，我们前瞻性地纳入了我们的数据库并回顾性分析了 50 例 51 个未破裂的动脉瘤患者，这些患者接受了 WEB 装置的治疗。一个独立的“核心实验室”评估了解剖学结果和潜在的 DSA 随访中的 WSM。我们将 WSM 比（WSMr）定义为工作投影中装置高度与宽度之间的相对指数，该指数评估了装置随时间的变形。
在整个随访期间，35/48 个动脉瘤（72.9%）观察到 WSM。有和没有 WSM 的充分闭塞率分别为 87.0%和 92.6%（P = 0.65）。30 个（85.7%）形状改变在短期随访（6 个月 DSA）时已经注意到。33 例患者进行了 2 次 DSA 对照，24 例患者可进行 WSMr 测量：18 例（75%）有 WSM，6 例（25%）无 WSM。在有 WSM 的患者中，WSMr 值在栓塞后为 0.80，在第一次 DSA 血管造影时为 0.52，在第二次 DSA 血管造影时为 0.42。
WEB 形状修改在一半以上的病例中观察到，但对充分闭塞率没有影响。这种 WSM 的定量方法强调，这种现象似乎是早期的，并随时间逐渐进展。这支持了这样一种假设，即 WSM 可能与动脉瘤愈合有关，而不是与外部压迫有关。
