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 language | English |
---|---|
Pages (from-to) | 27-34 |
Number of pages | 8 |
Journal | Neurosurgery |
Volume | 73 |
Issue number | 1 |
DOIs | |
Publication status | Published - Jul 2013 |
Fingerprint
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 journal › Article
}
TY - JOUR
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
Y1 - 2013/7
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.
KW - Aneurysms
KW - Endovascular treatment
KW - Flow Disruption
KW - Middle cerebral artery
KW - WEB
UR - http://www.scopus.com/inward/record.url?scp=84880570169&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880570169&partnerID=8YFLogxK
U2 - 10.1227/01.neu.0000429860.04276.c1
DO - 10.1227/01.neu.0000429860.04276.c1
M3 - Article
C2 - 23615104
AN - SCOPUS:84880570169
VL - 73
SP - 27
EP - 34
JO - Neurosurgery
JF - Neurosurgery
SN - 0148-396X
IS - 1
ER -