Browsing by Subject "Cerebral aneurysm"

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    ItemOpen Access
    A comparison between the CS-TOF and the CTA/DSA for WEB device management
    (Sage Publications, 2021-05-06) Algin, Oktay; Yuce, G.; Koc, U.; Ayberk, G.
    Purpose There is no study on the role of three-dimensional compressed sensing time of flight MR angiography (3D-CS-TOF) in the management of the WEB device. We evaluated the efficacy of 3-tesla 3D-CS-TOF for the management and follow-up of the WEB device implantations. Materials and methods Seventy-three aneurysms of 69 patients treated with the WEB device were retrospectively examined. Morphological parameters and embolization results of the aneurysms were assessed and compared on 3D-CS-TOF, CTA, and DSA images. Results Occluded, neck remnant, and recurrent aneurysms were observed in 61 (83.6%), 7 (9.6%), and 5 (6.8%) aneurysms, respectively. Inter- and intra-reader agreement values related to aneurysm size measurements were perfect. Aneurysms size, age, and proximal vessel tortuosity were negatively correlated with the visibility of the aneurysms and parent vessels on 3D-CS-TOF images (p = 0.043; p = 0.032; p < 0.001, respectively). Subarachnoid hemorrhage and age are associated with 3D-CS-TOF artifacts (p = 0.031; p = 0.005, respectively). 3D-CS-TOF findings are in perfect agreement with DSA or CT angiography (CTA) results (p < 0.001). Conclusion According to our results, 3D-CS-TOF can be an easy, fast, and reliable alternative for the management or follow-up of WEB assisted embolization.
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    Intrasaccular flow diverter (WEB) assisted cerebral aneurysm embolization
    (Nova Science Publishers, Inc., 2024-04-30) Algın, Oktay; Xianli Lv, MD
    Endovascular treatment has lower morbidity and mortality rates than surgical clipping. Woven Endo Bridge (WEB) device (also called an intrasaccular flow diverter) is a new and effective endovascular embolization method primarily used to treat wide-necked or bifurcated cerebral aneurysms. In WEB-assisted embolization, a specially structured scaffold-like metal cage (WEB) is placed within the aneurysm, and the blood flow is redirected to branch arteries. Thus, blood entry into the aneurysm sac is prevented, and the risk of rupture of the aneurysm is reduced. The advantages of WEB embolization are the shorter embolization time and the reduced need for antiaggregant usage and intra-/peri aneurysmal manipulations compared to coiling with or without stent placement. With the advancing technical developments (e.g., more visible single-layer wires), WEB devices are a safe alternative to other types of aneurysms or unusual locations (e.g., side-wall, PCOM origin, pericallosal, distal, or para-ophthalmic aneurysms. Adequate occlusion rates of the WEB devices were 84% at five years of follow-up. Complex morphology (e.g., the presence of irregular, multilocular, and/or partially thrombosed sac) and a large (> 10 mm) neck or width of the aneurysm were found to be associated with recurrences after the WEB placements.
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    Long-term efficacy and safety of wovenendobridge (web)-assisted cerebral aneurysm embolization
    (SAGE, 2022) Algin, Oktay; Corabay, Seniha; Ayberk, Gıyas
    Purpose: Long-term compaction, compression, migration, and recurrence rates of the WovenEndoBridge devices remain unknown. The purpose of this study was to detect these rates and safety profiles of the WovenEndoBridge within 7 years period. Materials and methods: Eighty-three aneurysms of 79 patients treated with the WovenEndoBridge device were retrospectively evaluated using an occlusion scale (e.g. complete occlusion, neck remnant, and aneurysm remnant) on angiography images. Results: The residual aneurysm was observed in 11 (13%) aneurysms. The mean and median diameters of the recurrent aneurysms were 6 and 7 mm. Most of the recurrent aneurysms were complex type and/or ruptured. Mean diameters and the neck-tobody ratios of all residual aneurysms in the preoperative imaging exams were above 4 mm and 0.6, respectively. The median values of preoperative height and neck measurements were higher in the recurrent aneurysms than in the adequate occlusion group (p=0.006, p=0.019, respectively). There was a statistically significant positive relationship between preoperative height/ neck measurements and the mean diameters of residual aneurysms (rs =0.32 and p=0.003; rs=0.28 and p=0.011, respectively). The WovenEndoBridge compaction/compression and migration were observed in 5 (45%) and 2 (18%) of the recurrent aneurysms. In 7 (64%) of the residual aneurysms, thrombosed areas were found within the aneurysm. In the follow-up period, four aneurysms (4.8%) were retreated due to widened residual aneurysm. Other aneurysms were improved or stable within 7 years. Discussion: Our adequate occlusion rate was 87%. Occlusion rates are less favorable than aneurysms with a long height, wide neck, or high neck-to-body ratio. Our study confirms the high safety and efficiency of the WovenEndoBridge. Compaction, compression, and/or migration of the WovenEndoBridge and the presence of intra-aneurysmal thrombosis are the main reasons for the recurrences.
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    Quantitative radial force measurements of Woven EndoBridge devices
    (Sage Publications Ltd., 2023-10-31) Kutbay, Uğurhan; Algın, Oktay
    Background Lateral/radial forces and the mechanical properties of Woven EndoBridge (WEB) devices have significant importance for therapeutic success. In other words, adequate apposition of the lateral wall of a cerebral aneurysm is critical for preventing recurrence or re-rupture risk. Objective This study aimed to investigate the pressure values applied by different WEB devices to the lateral walls of aneurysms and the relationships between these pressure measurements and the diameters of WEB devices. Methods By placing four WEB devices of different sizes and types between two rigid metal plates, the lateral forces applied by these WEB devices to plates of different apertures were measured quantitatively. We tested a single device of each size over multiple periods. The total number of examined WEB devices is four. Results There was a significant negative relationship between plate distances and pressure values (correlation coefficient:–0.956, p = 0.000). The lateral wall apposition pressure of a 4- or 5-mm aperture size was higher than a 6-mm aperture size for SL-type WEB devices with a 7-mm diameter. Similarly, the lateral wall apposition pressure detected for a 3- or 3.5-mm aperture size was higher than a 4-mm aperture size for W5-4.5-3 and W5-5-3.6. It was observed that maximum lateral wall pressure was detected in plate measurements of SLS-type devices compared to SL-type devices. The diameter and height values of 3 of the 4 unconstrained WEB devices analyzed differed from the catalog values. Conclusion It seems that SLS-type devices apply more pressure on the aneurysm's lateral borders than SL-type devices.