ABSTRACT
INTRODUCTION: Woven EndoBridge (WEB) is an innovative device for the treatment of intracranial aneurysms especially wide-necked bifurcation aneurysms. Here we present our experience with the WEB device. MATERIAL AND METHODS: Patients treated using only the WEB device between September 2014 and November 2018 were included in the study. Follow up imaging studies and medical records of the patients were retrospectively reviewed. RESULTS: Forty-two aneurysm of 42 patients (27 female, 15 male; median age: 56, range: 32-76) were treated using the WEB device. The mean diameter of the aneurysms was 6.6â¯mm (range: 3-12â¯mm). The neck diameter was ≥4â¯mm in 57% of the aneurysms. The locations of the aneurysms were the middle cerebral artery bifurcation in 29 (69%), basilar tip in 5 (12%), anterior communicating artery in 5 (12%), internal carotid artery tip in 2 (5%), and M1 segment of the middle cerebral artery in 1 (2%) of the patients. Five patients had subarachnoid hemorrhage due to aneurysm rupture. The device could be successfully deployed in all of the cases. There were control imaging studies available for 36 patients who were followed up for a median of 7â¯months (range: 1-33â¯months). Adequate occlusion was observed in 35 of these 36 patients (97%). There was no treatment related morbidity or mortality. CONCLUSION: Although long term follow-up data are not available, WEB intrasaccular flow disruptor seems to be effective and safe for intracranial bifurcation aneurysm treatment in the mid-term follow up.
Subject(s)
Aneurysm, Ruptured/therapy , Embolization, Therapeutic/methods , Endovascular Procedures/methods , Intracranial Aneurysm/therapy , Adult , Aged , Carotid Artery, Internal , Data Collection , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neck , Retrospective Studies , Treatment OutcomeABSTRACT
HistoryA 20-year old woman living in Turkey presented with a 3-month history of lower back pain. She had no medical history of note and was taking no medications. Complete blood count, C-reactive protein level, sedimentation rate, and creatinine, alanine aminotransferase, and aspartate aminotransferase levels were within normal limits. Anteroposterior pelvic radiography and unenhanced pelvic CT were performed to rule out sacroiliitis. The imaging findings were abnormal, and the patient underwent contrast-enhanced sacroiliac MRI. A few days later, she underwent contrast-enhanced (100 mL iohexol, Omnipaque; GE Healthcare, Cork, Ireland) abdominal CT because of right upper quadrant pain.
Subject(s)
Echinococcosis/diagnostic imaging , Joint Diseases/diagnostic imaging , Joint Diseases/parasitology , Sacroiliac Joint/diagnostic imaging , Sacroiliac Joint/parasitology , Adult , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Contrast Media , Diagnosis, Differential , Echinococcosis/drug therapy , Echinococcosis/surgery , Female , Humans , Image Enhancement/methods , Joint Diseases/therapy , Low Back Pain/parasitology , Magnetic Resonance Imaging/methods , Radiography, Abdominal/methods , Tomography, X-Ray Computed/methods , Young AdultABSTRACT
History A 20-year old woman living in Turkey presented with a 3-month history of lower back pain. She had no medical history of note and was taking no medications. Complete blood count, C-reactive protein level, sedimentation rate, and creatinine, alanine aminotransferase, and aspartate aminotransferase levels were within normal limits. Anteroposterior pelvic radiography and unenhanced pelvic CT were performed to rule out sacroiliitis. The imaging findings were abnormal, and the patient underwent contrast-enhanced sacroiliac MRI. A few days later, she underwent contrast-enhanced (100 mL iohexol, Omnipaque; GE Healthcare, Cork, Ireland) abdominal CT because of right upper quadrant pain. Figure 1: Anteroposterior pelvic radiograph. Figure 2: Axial unenhanced pelvic CT image. Figure 3a: (a) Coronal T2-weighted fat-saturated fast spin-echo (repetition time msec/echo time msec, 2220/57; section thickness, 4 mm), (b) axial unenhanced T1-weighted fat-saturated, and (c) axial contrast-enhanced (20 mL gadoteric acid, Dotarem; Guerbet, Roissy, France) T1-weighted fat-saturated (400/20; section thickness, 4 mm) sacroiliac images from MRI. Figure 3b: (a) Coronal T2-weighted fat-saturated fast spin-echo (repetition time msec/echo time msec, 2220/57; section thickness, 4 mm), (b) axial unenhanced T1-weighted fat-saturated, and (c) axial contrast-enhanced (20 mL gadoteric acid, Dotarem; Guerbet, Roissy, France) T1-weighted fat-saturated (400/20; section thickness, 4 mm) sacroiliac images from MRI. Figure 3c: (a) Coronal T2-weighted fat-saturated fast spin-echo (repetition time msec/echo time msec, 2220/57; section thickness, 4 mm), (b) axial unenhanced T1-weighted fat-saturated, and (c) axial contrast-enhanced (20 mL gadoteric acid, Dotarem; Guerbet, Roissy, France) T1-weighted fat-saturated (400/20; section thickness, 4 mm) sacroiliac images from MRI. Figure 4: Axial contrast-enhanced CT image of the abdomen.
