Intrasaccular flow diverter (WEB) assisted cerebral aneurysm embolization

Abstract

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.