Department of Neuroradiology, Hôpital Maison-Blanche, CHU Reims, Reims, France.
Department of Neuroradiology, Hôpital Maison-Blanche, CHU Reims, Reims, France
J Neurointerv Surg. 2022 Feb;14(2):164-168. doi: 10.1136/neurintsurg-2021-017379. Epub 2021 Mar 30.
Intrasaccular flow disruption with WEB is a safe and efficacious technique that has significantly changed endovascular management of wide-neck bifurcation aneurysms (WNBAs). Use of stent in combination with WEB is occasionally required. We analyzed the frequency of use, indications, safety, and efficacy of the WEB-stent combination.
All aneurysms treated with WEB and stent were extracted from a prospectively maintained database. Patient and aneurysm characteristics, complications, and anatomical results were independently analyzed by a physician independent of the procedures.
From June 2011 to January 2020, 152 patients with 157 aneurysms were treated with WEB. Of these, 17/152 patients (11.2%) with 19/157 aneurysms (12.1%) were treated with WEB device and stent. Indications were very wide neck with a branch emerging from the neck in 1/19 (5.2%) aneurysms and WEB protrusion in 18/19 (94.7%). At 1 month, no morbimortality was reported. At 6 months, anatomical results were complete aneurysm occlusion in 15/17 aneurysms (88.2%), neck remnant in 1/17 (5.9%), and aneurysm remnant in 1/17 (5.9%). At 12 months, there was complete aneurysm occlusion in 13/14 aneurysms (92.9%) and neck remnant in 1/14 (7.1%).
Combining WEB and stent is a therapeutic strategy to manage WNBA. In our series, this combination was used in 11.2% of patients treated with WEB, resulting in no morbidity or mortality with a high efficacy at 6 and 12 months (complete aneurysm occlusion in 88.2% and 92.9%, respectively).
WEB 腔内血流阻断是一种安全有效的技术，极大地改变了宽颈分叉动脉瘤（WNBA）的血管内治疗策略。有时需要支架与 WEB 联合使用。我们分析了 WEB-支架联合使用的频率、适应证、安全性和疗效。
从一个前瞻性维护的数据库中提取所有接受 WEB 和支架治疗的动脉瘤。由一名独立于手术的医生对患者和动脉瘤特征、并发症以及解剖学结果进行独立分析。
2011 年 6 月至 2020 年 1 月，共 152 例患者的 157 个动脉瘤接受了 WEB 治疗。其中，17 例患者（11.2%）的 19 个动脉瘤（12.1%）接受了 WEB 装置和支架联合治疗。适应证为颈部非常宽，有分支从颈部发出的动脉瘤 1 个（5.2%），WEB 突出的动脉瘤 18 个（94.7%）。1 个月时无死亡或严重并发症发生。6 个月时，17 个动脉瘤中完全闭塞 15 个（88.2%），残留颈部 1 个（5.9%），动脉瘤残留 1 个（5.9%）。12 个月时，完全闭塞 13 个（92.9%），残留颈部 1 个（7.1%）。
WEB 联合支架是治疗 WNBA 的一种治疗策略。在我们的系列研究中，这种联合治疗策略用于 11.2%接受 WEB 治疗的患者，6 个月和 12 个月时的疗效较高，无发病率或死亡率（完全闭塞率分别为 88.2%和 92.9%）。
