Department of Radiology and Neuroradiology, University Hospital of Cologne, Cologne, Germany.
Department of Neuroradiology, Ludwig's Maximilian University Munich, Munich, Germany.
Sci Rep. 2022 Jun 28;12(1):10899. doi: 10.1038/s41598-022-15113-w.
Endovascular coiling represents the standard treatment for basilar tip aneurysms. Some of these aneurysms are not amenable to conventional coiling due to a complex aneurysm geometry, hence, novel devices such as the Woven Endobridge (WEB) have been developed. We retrospectively compared WEB embolization and coiling for the treatment of unruptured basilar tip aneurysms. Patients treated with WEB or coiling at four centers were reviewed. Procedure-related complications, clinical outcome and angiographic results were retrospectively evaluated and compared. Forty patients treated with the WEB and 35 patients treated by coiling were included. Stent-assistance was more often necessary for coiling than for WEB embolization (71% vs 2.5%, p < 0.001). The technical success rates were 100% for both methods. The overall complication rates were not significantly different between groups (WEB: 5%, coil: 11%, p = 0.409). Procedural morbidity rates were 9% in the coiling group and 2.5% in the WEB group (p = 0.334). There was no mortality. Treatment duration was shorter for WEB implantation than for coiling (p = 0.048). At mid-term follow-up, complete occlusion, neck remnants and aneurysm remnants were observed in 89%, 4% and 7% for the WEB, respectively, and in 100%, 0% and 0% for coiling. While complication rates and mid-term angiographic outcome was comparable between the groups, the WEB was associated with a shorter treatment duration and required stent-assistance less frequently. The choice of the treatment modality should be made based on the specific aneurysm characteristics, the individual experience of the neurointerventionalist and patient preference.
血管内栓塞术是基底尖动脉瘤的标准治疗方法。由于动脉瘤的几何形状复杂，有些动脉瘤不适合常规栓塞，因此开发了新型装置，如编织式支架（WEB）。我们回顾性比较了 WEB 栓塞和线圈栓塞治疗未破裂基底尖动脉瘤的效果。回顾性分析了四家中心接受 WEB 或线圈治疗的患者。对与手术相关的并发症、临床结果和血管造影结果进行了回顾性评估和比较。共纳入 40 例接受 WEB 治疗和 35 例接受线圈治疗的患者。线圈治疗比 WEB 栓塞更常需要支架辅助（71% vs 2.5%，p<0.001）。两种方法的技术成功率均为 100%。两组总体并发症发生率无显著差异（WEB：5%，线圈：11%，p=0.409）。线圈组的手术发病率为 9%，WEB 组为 2.5%（p=0.334）。无死亡病例。WEB 植入的治疗时间短于线圈（p=0.048）。在中期随访中，WEB 组完全闭塞、瘤颈残留和瘤体残留分别为 89%、4%和 7%，线圈组分别为 100%、0%和 0%。虽然两组的并发症发生率和中期血管造影结果相当，但 WEB 治疗时间较短，支架辅助使用频率较低。治疗方式的选择应基于具体的动脉瘤特征、神经介入医生的个人经验和患者偏好。
