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PT  - JOURNAL ARTICLE
AU  - van Rooij, W.J.
AU  - Peluso, J.P.
AU  - Bechan, R.S.
AU  - Sluzewski, M.
TI  - WEB Treatment of Ruptured Intracranial Aneurysms
AID  - 10.3174/ajnr.A4811
DP  - 2016 Sep 01
TA  - American Journal of Neuroradiology
PG  - 1679--1683
VI  - 37
IP  - 9
4099  - http://www.ajnr.org/content/37/9/1679.short
4100  - http://www.ajnr.org/content/37/9/1679.full
SO  - Am. J. Neuroradiol.2016 Sep 01; 37
AB  - BACKGROUND AND PURPOSE: The Woven EndoBridge (WEB) device was recently introduced for intrasaccular treatment of wide-neck aneurysms without the need for adjunctive support. We present our first experience in using the WEB for small ruptured aneurysms.MATERIALS AND METHODS: During 11 months, 32 of 71 (45%) endovascularly treated acutely ruptured aneurysms were treated with the WEB. The patients were 12 men and 20 women, with a mean age of 61 years (range, 34–84 years). The mean aneurysm size was 4.9 mm, and 14 were ≤4 mm. Of 32 aneurysms, 24 (75%) had a wide neck.RESULTS: All 32 aneurysms were adequately occluded after WEB placement. There were no procedural ruptures and no complications related to the WEB device. No adjunctive stents or balloons were needed. In 3 patients, thromboembolic complications occurred. One patient developed an infarction, and 2 patients were asymptomatic. The procedural complication rate was 3%. Seven patients admitted in poor clinical grade conditions died during hospital admission due to the sequelae of SAH. In 18 patients with angiographic follow-up at 3 months, 16 aneurysms remained adequately occluded. Two aneurysms showed slight compression of the WEB without reopening. Clinical follow-up in the 25 patients who survived the hospital admission period revealed mRS 1–2 in 24 and mRS 4 in 1. There were no rebleeds from the ruptured aneurysms during follow-up.CONCLUSIONS: WEB treatment of small ruptured aneurysms was safe and effective without the need for anticoagulation, adjunctive stents, or balloons. Our preliminary experience indicates that the WEB may be a valuable alternative to coils in the treatment of acutely ruptured aneurysms.DLDual-LayerSLSingle-LayerSLSSingle-Layer SphereWEBWoven EndoBridge