Endovascular WEB flow disruption in middle cerebral artery aneurysms: Preliminary feasibility, clinical, and anatomical results in a multicenter study

Laurent Pierot, Joachim Klisch, Christophe Cognard, I. Szikora, Benjamin Mine, Krzysztof Kadziolka, Vojtech Sychra, Istvan Gubucz, Anne Christine Januel, Boris Lubicz

Research output: Contribution to journalArticle

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Abstract

BACKGROUND:: The endovascular treatment of middle cerebral artery (MCA) aneurysms with unfavorable anatomy (wide neck, unfavorable morphology) is frequently challenging. Flow disruption with the WEB is a potentially interesting endovascular treatment for this type of aneurysm. OBJECTIVE:: To report in a multicenter series the preliminary treatment experience of MCA aneurysms with flow disruption by the WEB. METHODS:: Thirty-three patients with 34 MCA aneurysms were treated with the WEB in 5 European centers. The ability to successfully deploy the WEB, procedure- and device-related adverse events, morbidity and mortality of the treatment, and short-term angiographic follow-up results were analyzed. RESULTS:: Most treated aneurysms were unruptured (85.3%) and were between 5 and 10 mm (85.3%) with a neck size ≥ 4 mm (88.2%). The treatment failed in 1 of the 34 aneurysms (2.9%) owing to a lack of appropriate device size. Treatment was performed exclusively with the WEB in 29 of 33 aneurysms (87.9%). Additional treatment (coiling and/or stenting) was used in 4 of 33 aneurysms (12.1%). Mortality of the treatment was 0.0% and morbidity was 3.1% (intraoperative rupture with modified Rankin Scale score of 3 at the 1-month follow-up). In short-term follow-up (range, 2-12 months), adequate occlusion (total occlusion or neck remnant) was observed in 83.3% of aneurysms. CONCLUSION:: WEB flow disruption seems to be a promising technique for the treatment of complex MCA aneurysms, particularly those with a wide neck or unfavorable dome-to-neck ratio.

Original languageEnglish
Pages (from-to)27-34
Number of pages8
JournalNeurosurgery
Volume73
Issue number1
DOIs
Publication statusPublished - Jul 2013

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Intracranial Aneurysm
Multicenter Studies
Aneurysm
Neck
Therapeutics
Morbidity
Equipment and Supplies
Mortality
Rupture
Anatomy

Keywords

  • Aneurysms
  • Endovascular treatment
  • Flow Disruption
  • Middle cerebral artery
  • WEB

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Endovascular WEB flow disruption in middle cerebral artery aneurysms : Preliminary feasibility, clinical, and anatomical results in a multicenter study. / Pierot, Laurent; Klisch, Joachim; Cognard, Christophe; Szikora, I.; Mine, Benjamin; Kadziolka, Krzysztof; Sychra, Vojtech; Gubucz, Istvan; Januel, Anne Christine; Lubicz, Boris.

In: Neurosurgery, Vol. 73, No. 1, 07.2013, p. 27-34.

Research output: Contribution to journalArticle

Pierot, Laurent ; Klisch, Joachim ; Cognard, Christophe ; Szikora, I. ; Mine, Benjamin ; Kadziolka, Krzysztof ; Sychra, Vojtech ; Gubucz, Istvan ; Januel, Anne Christine ; Lubicz, Boris. / Endovascular WEB flow disruption in middle cerebral artery aneurysms : Preliminary feasibility, clinical, and anatomical results in a multicenter study. In: Neurosurgery. 2013 ; Vol. 73, No. 1. pp. 27-34.
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abstract = "BACKGROUND:: The endovascular treatment of middle cerebral artery (MCA) aneurysms with unfavorable anatomy (wide neck, unfavorable morphology) is frequently challenging. Flow disruption with the WEB is a potentially interesting endovascular treatment for this type of aneurysm. OBJECTIVE:: To report in a multicenter series the preliminary treatment experience of MCA aneurysms with flow disruption by the WEB. METHODS:: Thirty-three patients with 34 MCA aneurysms were treated with the WEB in 5 European centers. The ability to successfully deploy the WEB, procedure- and device-related adverse events, morbidity and mortality of the treatment, and short-term angiographic follow-up results were analyzed. RESULTS:: Most treated aneurysms were unruptured (85.3{\%}) and were between 5 and 10 mm (85.3{\%}) with a neck size ≥ 4 mm (88.2{\%}). The treatment failed in 1 of the 34 aneurysms (2.9{\%}) owing to a lack of appropriate device size. Treatment was performed exclusively with the WEB in 29 of 33 aneurysms (87.9{\%}). Additional treatment (coiling and/or stenting) was used in 4 of 33 aneurysms (12.1{\%}). Mortality of the treatment was 0.0{\%} and morbidity was 3.1{\%} (intraoperative rupture with modified Rankin Scale score of 3 at the 1-month follow-up). In short-term follow-up (range, 2-12 months), adequate occlusion (total occlusion or neck remnant) was observed in 83.3{\%} of aneurysms. CONCLUSION:: WEB flow disruption seems to be a promising technique for the treatment of complex MCA aneurysms, particularly those with a wide neck or unfavorable dome-to-neck ratio.",
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T1 - Endovascular WEB flow disruption in middle cerebral artery aneurysms

T2 - Preliminary feasibility, clinical, and anatomical results in a multicenter study

AU - Pierot, Laurent

AU - Klisch, Joachim

AU - Cognard, Christophe

AU - Szikora, I.

AU - Mine, Benjamin

AU - Kadziolka, Krzysztof

AU - Sychra, Vojtech

AU - Gubucz, Istvan

AU - Januel, Anne Christine

AU - Lubicz, Boris

PY - 2013/7

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N2 - BACKGROUND:: The endovascular treatment of middle cerebral artery (MCA) aneurysms with unfavorable anatomy (wide neck, unfavorable morphology) is frequently challenging. Flow disruption with the WEB is a potentially interesting endovascular treatment for this type of aneurysm. OBJECTIVE:: To report in a multicenter series the preliminary treatment experience of MCA aneurysms with flow disruption by the WEB. METHODS:: Thirty-three patients with 34 MCA aneurysms were treated with the WEB in 5 European centers. The ability to successfully deploy the WEB, procedure- and device-related adverse events, morbidity and mortality of the treatment, and short-term angiographic follow-up results were analyzed. RESULTS:: Most treated aneurysms were unruptured (85.3%) and were between 5 and 10 mm (85.3%) with a neck size ≥ 4 mm (88.2%). The treatment failed in 1 of the 34 aneurysms (2.9%) owing to a lack of appropriate device size. Treatment was performed exclusively with the WEB in 29 of 33 aneurysms (87.9%). Additional treatment (coiling and/or stenting) was used in 4 of 33 aneurysms (12.1%). Mortality of the treatment was 0.0% and morbidity was 3.1% (intraoperative rupture with modified Rankin Scale score of 3 at the 1-month follow-up). In short-term follow-up (range, 2-12 months), adequate occlusion (total occlusion or neck remnant) was observed in 83.3% of aneurysms. CONCLUSION:: WEB flow disruption seems to be a promising technique for the treatment of complex MCA aneurysms, particularly those with a wide neck or unfavorable dome-to-neck ratio.

AB - BACKGROUND:: The endovascular treatment of middle cerebral artery (MCA) aneurysms with unfavorable anatomy (wide neck, unfavorable morphology) is frequently challenging. Flow disruption with the WEB is a potentially interesting endovascular treatment for this type of aneurysm. OBJECTIVE:: To report in a multicenter series the preliminary treatment experience of MCA aneurysms with flow disruption by the WEB. METHODS:: Thirty-three patients with 34 MCA aneurysms were treated with the WEB in 5 European centers. The ability to successfully deploy the WEB, procedure- and device-related adverse events, morbidity and mortality of the treatment, and short-term angiographic follow-up results were analyzed. RESULTS:: Most treated aneurysms were unruptured (85.3%) and were between 5 and 10 mm (85.3%) with a neck size ≥ 4 mm (88.2%). The treatment failed in 1 of the 34 aneurysms (2.9%) owing to a lack of appropriate device size. Treatment was performed exclusively with the WEB in 29 of 33 aneurysms (87.9%). Additional treatment (coiling and/or stenting) was used in 4 of 33 aneurysms (12.1%). Mortality of the treatment was 0.0% and morbidity was 3.1% (intraoperative rupture with modified Rankin Scale score of 3 at the 1-month follow-up). In short-term follow-up (range, 2-12 months), adequate occlusion (total occlusion or neck remnant) was observed in 83.3% of aneurysms. CONCLUSION:: WEB flow disruption seems to be a promising technique for the treatment of complex MCA aneurysms, particularly those with a wide neck or unfavorable dome-to-neck ratio.

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KW - Endovascular treatment

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