title: Woven Endobridge (WEB) Device for endovascular treatment of ruptured intracranial wide-neck aneurysms: a single-center experience.
abstract: BACKGROUND
  Endovascular treatment of ruptured wide-neck bifurcation aneurysms presents a challenge. While still under evaluation, the Woven Endobridge (WEB) aneurysm embolization system has so far shown promising results in the treatment of complex bifurcation aneurysms. We aimed to evaluate the feasibility and short-term follow-up of endovascular treatment of ruptured wide-neck aneurysm with the WEB device.
  
  
  METHODS
  Six patients referred to our institution for acute symptomatic subarachnoid hemorrhage (SAH) and treated with the WEB device were enrolled in this study. Clinical presentations, technical details, intraoperative and postoperative complications, and outcomes were recorded. Immediate and 3-month angiographic results were also evaluated.
  
  
  RESULTS
  Three middle cerebral artery (MCA) and three anterior communicating artery aneurysms were treated between 1 and 14 days after rupturing. Average dome width was 5.8 mm (range 5-7), average neck size was 4.5 mm (range 4-5), and average dome-to-neck ratio was 1.3 (range 1-1.7). The WEB system was the exclusive treatment and was successfully deployed in all cases. Per procedural thromboembolic events occurred in two cases and were treated with intra-arterial administration of antiplatelet agents without any clinical consequences. The modified Rankin Scale (mRS) score at discharge was 0 for all patients. The 3-month angiographic follow-up showed adequate occlusion in four of our six patients (67 %).
  
  
  CONCLUSIONS
  From this preliminary study, the high feasibility rate and lack of need for systematic antiplatelet agents favor the WEB device providing a solution for endovascular treatment of ruptured wide-neck bifurcation aneurysms during the acute phase. However, further studies are needed to evaluate the complication rate and long-term efficiency.
authors.affiliation: Beaujon Medical Center, NEURI - Interventional Neuroradiology, 100, boulevard Général Leclerc, 92110, Clichy, France, Jildaz.caroff@gmail.com.
authors.forename: Jildaz
authors.initials: J
authors.lastname: Caroff
authors.forename: Cristian
authors.initials: C
authors.lastname: Mihalea
authors.forename: Francesco
authors.initials: F
authors.lastname: Dargento
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Neki
authors.forename: Léon
authors.initials: L
authors.lastname: Ikka
authors.forename: Nidhal
authors.initials: N
authors.lastname: Benachour
authors.forename: Jacques
authors.initials: J
authors.lastname: Moret
authors.forename: Laurent
authors.initials: L
authors.lastname: Spelle
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000473:pathology / Q000601:surgery*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies