title: Intrasaccular Flow Disruption in Acutely Ruptured Aneurysms: A Multicenter Retrospective Review of the Use of the WEB.
abstract: OBJECTIVE
  Use of the WEB intra-aneurysmal flow-disruption device in unruptured wide-neck bifurcation aneurysms has proven safety and efficacy. However, ruptured aneurysms are underrepresented in existing studies. This retrospective multicenter study describes the use of the WEB in patients with a ruptured intracranial aneurysm.
  
  
  METHODS
  Ten centers contributed to this study. Clinical and procedural data of 47 patients with 52 aneurysms were analyzed retrospectively together with follow-up angiographies.
  
  
  RESULTS
  There were 37 anterior and 15 posterior circulation aneurysms with a neck size of ≥4 mm in 49 of 52 (94%) aneurysms; 45 (87%) aneurysms were <10 mm, and 2 were partially thrombosed. Successful placement of the WEB was possible in every case. Adjunctive devices were used in 8 of 52 (15%) aneurysms. Thromboembolic events were observed in 4 of 52 (8%) patients. Adverse events occurred in 15 patients with 16 aneurysms, 9 of which were potentially related to the WEB procedure (3 thromboembolic events, 5 protrusions, and 1 perforations; 2 perforations were caused by the wire or catheter), but none had a clinical impact. Four patients were retreated. Short-term follow-up in 25 of 39 patients revealed complete occlusion in 15 of 25 (60%), 5 of 25 (20%) with residual neck, and 5 of 25 (20%) with residual aneurysm filling. Short- to midterm imaging in 9 of 25 patients revealed complete occlusion in 5 (55.6%), residual neck in 2 (22%), and residual aneurysm filling in 2 (22%). Of 47 patients, 23 (49%) had an mRS score of 0, 1, or 2; 13 (28%) had an mRS score of 3 or 4; and none had an mRS score of 5 at discharge.
  
  
  CONCLUSIONS
  This retrospective series showed good procedural safety, feasibility, and stability of midterm occlusion in ruptured wide-neck bifurcation aneurysms.
authors.affiliation: From the Department of Radiology (T.L., C.K.), Universitätsklinikum Köln, Cologne, Germany thomas.liebig@uk-koeln.de.
authors.forename: T
authors.initials: T
authors.lastname: Liebig
authors.affiliation: From the Department of Radiology (T.L., C.K.), Universitätsklinikum Köln, Cologne, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Kabbasch
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology (C.S., J.K.), Helios General Hospital, Erfurt, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Strasilla
authors.affiliation: Department of Diagnostic Imaging and Neuroradiology (A.B.), Klinikum Augsburg, Augsburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Berlis
authors.affiliation: Department of Neuroradiology (W.W.), Knappschaftskrankenhaus, Recklinghausen, Germany Department of Neuroradiology (W.W.), Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Weber
authors.affiliation: Department of Neuroradiology (L.P.), Hôpital Maison-Blanche, Université Reims-Champagne-Ardenne, Reims, France.
authors.forename: L
authors.initials: L
authors.lastname: Pierot
authors.affiliation: Leeds General Infirmary (T.P.), Leeds, United Kingdom.
authors.forename: T
authors.initials: T
authors.lastname: Patankar
authors.affiliation: Department of Neuroimaging (X.B.), CHU Pellegrin, Bordeaux, France.
authors.forename: X
authors.initials: X
authors.lastname: Barreau
authors.affiliation: Southern General Hospital (J.D.), Glasgow, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Dervin
authors.affiliation: Department of Neuroradiology (A.K., S.R.), Klinikum Deggendorf, Deggendorf, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kuršumović
authors.affiliation: Department of Neuroradiology (A.K., S.R.), Klinikum Deggendorf, Deggendorf, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Rath
authors.affiliation: Department of Neuroradiology (B.L.), Erasme University Hospital, Brussels, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Lubicz
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology (C.S., J.K.), Helios General Hospital, Erfurt, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Klisch
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome