Browsing by Subject "Intrasaccular flow diverter"

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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.