Retreatment Strategies in Aneurysm Woven Endobridge Recurrences: A Case Series.
Publication/Presentation Date
4-1-2022
Abstract
BACKGROUND: The treatment of wide-necked and bifurcation aneurysms has become a common indication for the Woven Endobridge (WEB) device. In many instances, WEB embolization fails and retreatment strategies for the recanalized aneurysms have not been established and may be challenging.
OBJECTIVE: To report an experience with retreatment strategies after WEB failure in 7 cases involving various aneurysm shapes, sizes, and location using multiple strategies including endovascular modalities and microsurgical clip ligation.
METHODS: Data were retrospectively collected from 1 high-volume cerebrovascular center for 7 patients treated with a WEB device for an aneurysm who subsequently required retreatment for that same aneurysm from 2015 through January 2021.
RESULTS: We identified 7 patients with WEB recurrences over a period of 6 years. Four patients initially presented with incidental findings, whereas 3 patients presented with subarachnoid hemorrhage. One patient was lost to follow-up and presented with a rerupture, whereas the 6 other patients were diagnosed with routine follow-up. Two patients received clip ligation, 2 had simple coil embolization, 1 had stent-assisted coil embolization, 1 had a flow-diverting stent, and 1 patient required 2 retreatments; he received stent-assisted coil embolization for the first retreatment and a simple coil embolization for the second retreatment. All patients had excellent angiographic outcomes and no complications.
CONCLUSION: The authors conclude that aneurysm recurrence after WEB is very diverse, and no single modality can properly address all recurrences. Rather, an individualized approach based on aneurysm features, neurointerventionalist expertise, and patient preference should be implemented.
Volume
22
Issue
4
First Page
201
Last Page
207
ISSN
2332-4260
Published In/Presented At
Abbas, R., El Naamani, K., Sweid, A., Birkenstock, L., Ruiz, R., Tjoumakaris, S., Gooch, M. R., Herial, N. A., Rosenwasser, R. H., & Jabbour, P. (2022). Retreatment Strategies in Aneurysm Woven Endobridge Recurrences: A Case Series. Operative neurosurgery (Hagerstown, Md.), 22(4), 201–207. https://doi.org/10.1227/ONS.0000000000000115
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
35240675
Department(s)
Administration and Leadership
Document Type
Article