WEB-DL endovascular treatment of wide-neck bifurcation aneurysms: Short- and midterm results in a European study

B. Lubicz, J. Klisch, J. Y. Gauvrit, I. Szikora, M. Leonardi, T. Liebig, N. P. Nuzzi, E. Boccardi, F. D. Paola, M. Holtmannspötter, W. Weber, E. Calgliari, V. Sychra, B. Mine, Laurent Pierot

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Abstract

BACKGROUND AND PURPOSE: Flow disruption with the WEB-DL device has been used safely for the treatment of wide-neck bifurcation aneurysms, but the stability of aneurysm occlusion after this treatment is unknown. This retrospective multicenter European study analyzed short- and midterm data in patients treated with WEB-DL. MATERIALS AND METHODS: Twelve European neurointerventional centers participated in the study. Clinical data and pre- and postoperative short- and midterm images were collected. An experienced interventional neuroradiologist independently analyzed the images. Aneurysm occlusion was classified into 4 grades: complete occlusion, opacification of the proximal recess of the device, neck remnant, and aneurysm remnant. RESULTS: Forty-five patients (34 women and 11 men) 35-74 years of age (mean, 56.3 ± 9.6 years) with 45 aneurysms treated with the WEB device were included. Aneurysm locations were the middle cerebral artery in 26 patients, the posterior circulation in 13 patients, the anterior communicating artery in 5 patients, and the internal carotid artery terminus in 1 patient. Forty-two aneurysms were unruptured. Good clinical outcome (mRS <2) was observed in 93.3% of patients at the last follow-up. Adequate occlusion (complete occlusion, opacification of the proximal recess, or neck remnant) was observed in 30/37 patients (81.1%) in short-term follow-up (median, 6 months) and in 26/29 patients (89.7%) in midterm follow-up (median, 13 months). Worsening of the aneurysm occlusion was observed in 2/28 patients (7.1%) at midterm follow-up. CONCLUSIONS: The results suggest that the WEB endovascular treatment of wide-neck bifurcation aneurysms offers stable occlusion in a class of aneurysms that are historically unstable. Additionally, our data show that opacification of the WEB recess can be delineated from true neck or aneurysm remnants.

Original languageEnglish
Pages (from-to)432-438
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume35
Issue number3
DOIs
Publication statusPublished - 2014

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Aneurysm
Neck
Therapeutics
Equipment and Supplies
Middle Cerebral Artery
Internal Carotid Artery
Multicenter Studies
Arteries

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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WEB-DL endovascular treatment of wide-neck bifurcation aneurysms : Short- and midterm results in a European study. / Lubicz, B.; Klisch, J.; Gauvrit, J. Y.; Szikora, I.; Leonardi, M.; Liebig, T.; Nuzzi, N. P.; Boccardi, E.; Paola, F. D.; Holtmannspötter, M.; Weber, W.; Calgliari, E.; Sychra, V.; Mine, B.; Pierot, Laurent.

In: American Journal of Neuroradiology, Vol. 35, No. 3, 2014, p. 432-438.

Research output: Contribution to journalArticle

Lubicz, B, Klisch, J, Gauvrit, JY, Szikora, I, Leonardi, M, Liebig, T, Nuzzi, NP, Boccardi, E, Paola, FD, Holtmannspötter, M, Weber, W, Calgliari, E, Sychra, V, Mine, B & Pierot, L 2014, 'WEB-DL endovascular treatment of wide-neck bifurcation aneurysms: Short- and midterm results in a European study', American Journal of Neuroradiology, vol. 35, no. 3, pp. 432-438. https://doi.org/10.3174/ajnr.A3869
Lubicz, B. ; Klisch, J. ; Gauvrit, J. Y. ; Szikora, I. ; Leonardi, M. ; Liebig, T. ; Nuzzi, N. P. ; Boccardi, E. ; Paola, F. D. ; Holtmannspötter, M. ; Weber, W. ; Calgliari, E. ; Sychra, V. ; Mine, B. ; Pierot, Laurent. / WEB-DL endovascular treatment of wide-neck bifurcation aneurysms : Short- and midterm results in a European study. In: American Journal of Neuroradiology. 2014 ; Vol. 35, No. 3. pp. 432-438.
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abstract = "BACKGROUND AND PURPOSE: Flow disruption with the WEB-DL device has been used safely for the treatment of wide-neck bifurcation aneurysms, but the stability of aneurysm occlusion after this treatment is unknown. This retrospective multicenter European study analyzed short- and midterm data in patients treated with WEB-DL. MATERIALS AND METHODS: Twelve European neurointerventional centers participated in the study. Clinical data and pre- and postoperative short- and midterm images were collected. An experienced interventional neuroradiologist independently analyzed the images. Aneurysm occlusion was classified into 4 grades: complete occlusion, opacification of the proximal recess of the device, neck remnant, and aneurysm remnant. RESULTS: Forty-five patients (34 women and 11 men) 35-74 years of age (mean, 56.3 ± 9.6 years) with 45 aneurysms treated with the WEB device were included. Aneurysm locations were the middle cerebral artery in 26 patients, the posterior circulation in 13 patients, the anterior communicating artery in 5 patients, and the internal carotid artery terminus in 1 patient. Forty-two aneurysms were unruptured. Good clinical outcome (mRS <2) was observed in 93.3{\%} of patients at the last follow-up. Adequate occlusion (complete occlusion, opacification of the proximal recess, or neck remnant) was observed in 30/37 patients (81.1{\%}) in short-term follow-up (median, 6 months) and in 26/29 patients (89.7{\%}) in midterm follow-up (median, 13 months). Worsening of the aneurysm occlusion was observed in 2/28 patients (7.1{\%}) at midterm follow-up. CONCLUSIONS: The results suggest that the WEB endovascular treatment of wide-neck bifurcation aneurysms offers stable occlusion in a class of aneurysms that are historically unstable. Additionally, our data show that opacification of the WEB recess can be delineated from true neck or aneurysm remnants.",
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T1 - WEB-DL endovascular treatment of wide-neck bifurcation aneurysms

T2 - Short- and midterm results in a European study

AU - Lubicz, B.

AU - Klisch, J.

AU - Gauvrit, J. Y.

AU - Szikora, I.

AU - Leonardi, M.

AU - Liebig, T.

AU - Nuzzi, N. P.

AU - Boccardi, E.

AU - Paola, F. D.

AU - Holtmannspötter, M.

AU - Weber, W.

AU - Calgliari, E.

AU - Sychra, V.

AU - Mine, B.

AU - Pierot, Laurent

PY - 2014

Y1 - 2014

N2 - BACKGROUND AND PURPOSE: Flow disruption with the WEB-DL device has been used safely for the treatment of wide-neck bifurcation aneurysms, but the stability of aneurysm occlusion after this treatment is unknown. This retrospective multicenter European study analyzed short- and midterm data in patients treated with WEB-DL. MATERIALS AND METHODS: Twelve European neurointerventional centers participated in the study. Clinical data and pre- and postoperative short- and midterm images were collected. An experienced interventional neuroradiologist independently analyzed the images. Aneurysm occlusion was classified into 4 grades: complete occlusion, opacification of the proximal recess of the device, neck remnant, and aneurysm remnant. RESULTS: Forty-five patients (34 women and 11 men) 35-74 years of age (mean, 56.3 ± 9.6 years) with 45 aneurysms treated with the WEB device were included. Aneurysm locations were the middle cerebral artery in 26 patients, the posterior circulation in 13 patients, the anterior communicating artery in 5 patients, and the internal carotid artery terminus in 1 patient. Forty-two aneurysms were unruptured. Good clinical outcome (mRS <2) was observed in 93.3% of patients at the last follow-up. Adequate occlusion (complete occlusion, opacification of the proximal recess, or neck remnant) was observed in 30/37 patients (81.1%) in short-term follow-up (median, 6 months) and in 26/29 patients (89.7%) in midterm follow-up (median, 13 months). Worsening of the aneurysm occlusion was observed in 2/28 patients (7.1%) at midterm follow-up. CONCLUSIONS: The results suggest that the WEB endovascular treatment of wide-neck bifurcation aneurysms offers stable occlusion in a class of aneurysms that are historically unstable. Additionally, our data show that opacification of the WEB recess can be delineated from true neck or aneurysm remnants.

AB - BACKGROUND AND PURPOSE: Flow disruption with the WEB-DL device has been used safely for the treatment of wide-neck bifurcation aneurysms, but the stability of aneurysm occlusion after this treatment is unknown. This retrospective multicenter European study analyzed short- and midterm data in patients treated with WEB-DL. MATERIALS AND METHODS: Twelve European neurointerventional centers participated in the study. Clinical data and pre- and postoperative short- and midterm images were collected. An experienced interventional neuroradiologist independently analyzed the images. Aneurysm occlusion was classified into 4 grades: complete occlusion, opacification of the proximal recess of the device, neck remnant, and aneurysm remnant. RESULTS: Forty-five patients (34 women and 11 men) 35-74 years of age (mean, 56.3 ± 9.6 years) with 45 aneurysms treated with the WEB device were included. Aneurysm locations were the middle cerebral artery in 26 patients, the posterior circulation in 13 patients, the anterior communicating artery in 5 patients, and the internal carotid artery terminus in 1 patient. Forty-two aneurysms were unruptured. Good clinical outcome (mRS <2) was observed in 93.3% of patients at the last follow-up. Adequate occlusion (complete occlusion, opacification of the proximal recess, or neck remnant) was observed in 30/37 patients (81.1%) in short-term follow-up (median, 6 months) and in 26/29 patients (89.7%) in midterm follow-up (median, 13 months). Worsening of the aneurysm occlusion was observed in 2/28 patients (7.1%) at midterm follow-up. CONCLUSIONS: The results suggest that the WEB endovascular treatment of wide-neck bifurcation aneurysms offers stable occlusion in a class of aneurysms that are historically unstable. Additionally, our data show that opacification of the WEB recess can be delineated from true neck or aneurysm remnants.

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