title: Woven Endobridge (WEB) device for endovascular treatment of complex unruptured aneurysms-a single center experience.
abstract: BACKGROUND
  The introduction of the Woven Endobridge (WEB) device increases the feasibility of endovascular treatment of wide-neck bifurcation aneurysms with limitations given by currently available sizes and shapes of the device. Parallel to other studies, we used the new device for selected patients who were no optimal candidates for established techniques like neurosurgical clipping or endovascular coiling. We aimed to report the angiographic and clinical results of WEB implantations or combinations between WEB and coiling or intracranial stents.
  
  
  METHODS
  We reviewed the records of n = 23 interventions in 22 patients with unruptured wide-neck aneurysms (UIA) who were assigned for aneurysm treatment with the use of the WEB or adjunctive techniques. Interventional procedures and clinical and angiographic outcomes are reported for the periprocedural phase and in mid-term FU.
  
  
  RESULTS
  Of the included 22 patients, six patients needed additional coiling, intracranial stenting, or implantation of a flow diverter. WEB implantation was technically feasible in 22 out of the 23 interventions. Follow-up angiographic imaging proved total or subtotal occlusion of the aneurysm in 19 of 22 cases. Two minor recurrences remained stable during a period of 15 months. One patient with a partially thrombosed giant MCA aneurysm had a major recurrence and was retreated with a second WEB in combination with coiling.
  
  
  CONCLUSIONS
  Despite of unfavorable anatomic conditions, broad-based and large UIA endovascular treatment with the WEB and adjunctive techniques was feasible with a low risk of complications and promising occlusion rates in mid-term follow-up.
authors.affiliation: Institute of Neuroradiology, Hospital of Goethe University, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany. stephanie.lescher@kgu.de.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lescher
authors.affiliation: Institute of Neuroradiology, Hospital of Goethe University, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: du Mesnil de Rochemont
authors.affiliation: Institute of Neuroradiology, Hospital of Goethe University, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Berkefeld
mesh_terms: D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Complex aneurysms; Endovascular treatment; Intrasaccular flow-disruption; WEB