Background Woven EndoBridge (WEB) deployment remains challenging in aneurysms with a complex shape or orientation.Objective To show that embolization of wide-neck bifurcation aneurysms using the WEB device balloon remodeling-assisted technique is a feasible and elegant endovascular solution compared with other techniques, such as balloon remodeling or stent-assisted coiling.Materials and methods 10 cases (10 aneurysms in 9 patients) of balloon remodeling-assisted WEB treatment of unruptured complex bifurcation aneurysms were treated in our institution and retrospectively analyzed. Details of clinical presentations, technical details, perioperative and postoperative complications, and outcomes were collected. Immediate and long-term angiographic results were also evaluated.Results A neurysms included six middle cerebral artery aneurysms, one anterior communicating artery aneurysm, one posterior communicating artery aneurysm, one basilar artery aneurysm, and one T-shaped carotid aneurysm. Mean dome width was 6.55 mm, mean neck size 4.5 mm, mean height 4.79 mm, and mean dome-to-neck ratio was 1: 1.46. Treatment was performed exclusively with the balloon remodeling-assisted WEB technique in all cases. The device was successfully deployed in every case. Periprocedural thromboembolic or hemorrhagic events did not occur. The modified Rankin Scale score at discharge was 0 for all patients. At mid-term or long-term angiographic follow-up, adequate occlusion was observed in 7 aneurysms from 8 controlled cases (87.5%), and one patient (2 aneurysms) did not have angiographic follow-up.Conclusion The balloon remodeling-assisted WEB technique seems to be a safe and effective solution for endovascular treatment of unruptured wide-neck bifurcation aneurysms with specific complex anatomy. However, further studies are needed to evaluate the rate of complications and long-term efficacy.

Mihalea, C., Escalard, S., Caroff, J., Ikka, L., Rouchaud, A., Da Ros, V., et al. (2019). Balloon remodeling-assisted Woven EndoBridge technique: Description and feasibility for complex bifurcation aneurysms. JOURNAL OF NEUROINTERVENTIONAL SURGERY, 11(4), 386-389 [10.1136/neurintsurg-2018-014104].

Balloon remodeling-assisted Woven EndoBridge technique: Description and feasibility for complex bifurcation aneurysms

Da Ros V.;
2019-04-01

Abstract

Background Woven EndoBridge (WEB) deployment remains challenging in aneurysms with a complex shape or orientation.Objective To show that embolization of wide-neck bifurcation aneurysms using the WEB device balloon remodeling-assisted technique is a feasible and elegant endovascular solution compared with other techniques, such as balloon remodeling or stent-assisted coiling.Materials and methods 10 cases (10 aneurysms in 9 patients) of balloon remodeling-assisted WEB treatment of unruptured complex bifurcation aneurysms were treated in our institution and retrospectively analyzed. Details of clinical presentations, technical details, perioperative and postoperative complications, and outcomes were collected. Immediate and long-term angiographic results were also evaluated.Results A neurysms included six middle cerebral artery aneurysms, one anterior communicating artery aneurysm, one posterior communicating artery aneurysm, one basilar artery aneurysm, and one T-shaped carotid aneurysm. Mean dome width was 6.55 mm, mean neck size 4.5 mm, mean height 4.79 mm, and mean dome-to-neck ratio was 1: 1.46. Treatment was performed exclusively with the balloon remodeling-assisted WEB technique in all cases. The device was successfully deployed in every case. Periprocedural thromboembolic or hemorrhagic events did not occur. The modified Rankin Scale score at discharge was 0 for all patients. At mid-term or long-term angiographic follow-up, adequate occlusion was observed in 7 aneurysms from 8 controlled cases (87.5%), and one patient (2 aneurysms) did not have angiographic follow-up.Conclusion The balloon remodeling-assisted WEB technique seems to be a safe and effective solution for endovascular treatment of unruptured wide-neck bifurcation aneurysms with specific complex anatomy. However, further studies are needed to evaluate the rate of complications and long-term efficacy.
apr-2019
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
English
aneurysm; balloon; intervention; stent; technique; Adult; Aged; Cerebral Angiography; Embolization, Therapeutic; Endovascular Procedures; Feasibility Studies; Female; Humans; Intracranial Aneurysm; Male; Middle Aged; Patient Discharge; Postoperative Complications; Retrospective Studies; Thromboembolism; Treatment Outcome; Stents
Mihalea, C., Escalard, S., Caroff, J., Ikka, L., Rouchaud, A., Da Ros, V., et al. (2019). Balloon remodeling-assisted Woven EndoBridge technique: Description and feasibility for complex bifurcation aneurysms. JOURNAL OF NEUROINTERVENTIONAL SURGERY, 11(4), 386-389 [10.1136/neurintsurg-2018-014104].
Mihalea, C; Escalard, S; Caroff, J; Ikka, L; Rouchaud, A; Da Ros, V; Pagiola, I; Marenco De La Torre, Jj; Yasuda, T; Popa, Bv; Ples, H; Benachour, N; Ozanne, A; Moret, J; Spelle, L
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/234035
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