Title

Retreatment of Residual and Recurrent Aneurysms After Embolization With the Woven EndoBridge Device: Multicenter Case Series

UMMS Affiliation

Department of Radiology

Publication Date

2022-05-01

Document Type

Article

Disciplines

Cardiovascular Diseases | Neurology | Neurosurgery | Radiology

Abstract

BACKGROUND: The Woven EndoBridge (WEB) device (Terumno Corp. [parent company of Microvention]) was approved by the U.S. Food and Drug Administration as the first intrasaccular device for intracranial aneurysm treatment in December 2018. Its use has become more common since then, but both trial results and postmarket experiences have raised questions about the efficacy in achieving complete aneurysm obliteration. Retreatment after WEB embolization has not been extensively discussed.

OBJECTIVE: To discuss the incidence and retreatment of aneurysms after initial WEB embolization.

METHODS: Retrospective review across 13 institutions identified all occurrences of WEB retreatment within neurovascular databases. Details regarding demographics, aneurysm characteristics, treatment considerations, clinical outcomes, and aneurysm occlusion were obtained and analyzed.

RESULTS: Thirty aneurysms were retreated in 30 patients in a cohort of 342 WEB-treated aneurysms. The retreatment rate was 8.8%. Endovascular methods were used for 23 cases, and 7 were treated surgically. Two aneurysms presented with rehemorrhage after initial WEB embolization. Endovascular treatments included stent-assisted coiling (12), flow diversion (7), coiling (2), PulseRider (Johnson and Johnson)-assisted coiling (1), and additional WEB placement (1). Surgical treatments included primary clipping (6) and Hunterian ligation (1). There were no major complications within the study group.

CONCLUSION: WEB retreatments were successfully performed by a variety of techniques, including stent-assisted coiling, clipping, and flow diversion as the most common. These procedures were performed safely with subsequent obliteration of most aneurysms. The potential need for retreatment of aneurysms should be considered during primary WEB treatments.

DOI of Published Version

10.1227/neu.0000000000001883

Source

Srinivasan VM, Dmytriw AA, Regenhardt RW, Vicenty-Padilla J, Alotaibi NM, Levy E, Waqas M, Cherian J, Johnson JN, Jabbour P, Sweid A, Gross B, Starke RM, Puri A, Massari F, Griessenauer CJ, Catapano JS, Rutledge C, Tanweer O, Yashar P, Cortez GM, Aziz-Sultan MA, Patel AB, Ducruet AF, Albuquerque FC, Hanel RA, Lawton MT, Kan P. Retreatment of Residual and Recurrent Aneurysms After Embolization With the Woven EndoBridge Device: Multicenter Case Series. Neurosurgery. 2022 May 1;90(5):569-580. doi: 10.1227/neu.0000000000001883. PMID: 35244028. Link to article on publisher's site

Journal/Book/Conference Title

Neurosurgery

Comments

Full author list omitted for brevity. For the full list of authors, see article.

Related Resources

Link to Article in PubMed

PubMed ID

35244028

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