WEB Treatment of Ruptured Intracranial Aneurysms.
The Woven EndoBridge (WEB) device was recently introduced for intrasaccular treatment of wide-neck aneurysms without the need for adjunctive support. We present our first experience in using the WEB for small ruptured aneurysms.



During 11 months, 32 of 71 (45%) endovascularly treated acutely ruptured aneurysms were treated with the WEB. The patients were 12 men and 20 women, with a mean age of 61 years (range, 34-84 years). The mean aneurysm size was 4.9 mm, and 14 were ≤4 mm. Of 32 aneurysms, 24 (75%) had a wide neck.



All 32 aneurysms were adequately occluded after WEB placement. There were no procedural ruptures and no complications related to the WEB device. No adjunctive stents or balloons were needed. In 3 patients, thromboembolic complications occurred. One patient developed an infarction, and 2 patients were asymptomatic. The procedural complication rate was 3%. Seven patients admitted in poor clinical grade conditions died during hospital admission due to the sequelae of SAH. In 18 patients with angiographic follow-up at 3 months, 16 aneurysms remained adequately occluded. Two aneurysms showed slight compression of the WEB without reopening. Clinical follow-up in the 25 patients who survived the hospital admission period revealed mRS 1-2 in 24 and mRS 4 in 1. There were no rebleeds from the ruptured aneurysms during follow-up.



WEB treatment of small ruptured aneurysms was safe and effective without the need for anticoagulation, adjunctive stents, or balloons. Our preliminary experience indicates that the WEB may be a valuable alternative to coils in the treatment of acutely ruptured aneurysms.
From the Department of Radiology, Sint Elisabeth Ziekenhuis, Tilburg, the Netherlands. radiol@eztilburg.nl.
W J
0000-0001-5931-1186
WJ
van Rooij
From the Department of Radiology, Sint Elisabeth Ziekenhuis, Tilburg, the Netherlands.
J P
0000-0002-5957-9091
JP
Peluso
From the Department of Radiology, Sint Elisabeth Ziekenhuis, Tilburg, the Netherlands.
R S
0000-0002-8674-6326
RS
Bechan
From the Department of Radiology, Sint Elisabeth Ziekenhuis, Tilburg, the Netherlands.
M
0000-0002-3949-5958
M
Sluzewski
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D015607:Stents