title: Should indications for WEB aneurysm treatment be enlarged? Report of a series of 20 patients with aneurysms in "atypical" locations for WEB treatment.
abstract: OBJECTIVE
  Flow disruption with the WEB device is an innovative technique for the endovascular treatment of wide neck bifurcation aneurysms. Good clinical practice trials have shown high safety of this treatment with good efficacy. Technical developments (single layer devices and smaller microcatheters) facilitate the treatment, potentially leading to enlargement of indications. This series is collecting aneurysms in "atypical" locations for WEB treatment and analyzing safety and efficacy of this treatment.
  
  
  METHODS
  In each participating center, patients with aneurysms treated with WEB were prospectively included in a local database. Patients treated for aneurysms in "atypical" locations were extracted. Patient and aneurysm characteristics, intraoperative complications, and anatomical results at the end of the procedure and at last follow-up were collected and analyzed.
  
  
  RESULTS
  Five French neurointerventional centers included 20 patients with 20 aneurysms in "atypical" locations for WEB treatment treated with WEB. Aneurysm locations were ICA carotid-ophthalmic in 9 aneurysms (45.0%), ICA posterior communicating in 4 (20.0%), Pericallosal artery in 5 (25.0%), and basilar artery between P1 and superior cerebellar artery in 2 (10.0%). There were no complications (thromboembolic or intraoperative rupture) in this series. At follow-up (mean: 7.4 months), adequate occlusion was obtained in 100.0% of aneurysms.
  
  
  CONCLUSIONS
  This series confirms that it is possible to enlarge indications of WEB treatment to "atypical" locations with good safety and efficacy. These data have to be confirmed in large prospective series.
authors.affiliation: Department of neuroradiology, hôpital Maison-Blanche, université de Champagne-Ardenne, CHU de Reims, 51100 Reims, France. Electronic address: lpierot@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Pierot
authors.affiliation: Department of neuroradiology and endovascular therapy, Jean-Minjoz hospital, CHRU de Besançon, Franche Comté university school of medecine, 25000 Besançon, France.
authors.forename: A
authors.initials: A
authors.lastname: Biondi
authors.affiliation: Department of neuroradiology, Bretonneau hospital, university François-Rabelais, 37000 Tours, France.
authors.forename: A-P
authors.initials: AP
authors.lastname: Narata
authors.affiliation: Department of interventional neuroradiology, CHU Kremlin-Bicêtre, 94270 Kremlin-Bicêtre, France.
authors.forename: C
authors.initials: C
authors.lastname: Mihalea
authors.affiliation: Department of diagnostic and interventional neuroradiology, CHU de Toulouse, 31000 Toulouse, France.
authors.forename: A-C
authors.initials: AC
authors.lastname: Januel
authors.affiliation: Department of neuroradiology, hôpital Maison-Blanche, université de Champagne-Ardenne, CHU de Reims, 51100 Reims, France.
authors.forename: G
authors.initials: G
authors.lastname: Metaxas
authors.affiliation: Department of neuroradiology, Bretonneau hospital, university François-Rabelais, 37000 Tours, France.
authors.forename: R
authors.initials: R
authors.lastname: Bibi
authors.affiliation: Department of interventional neuroradiology, CHU Kremlin-Bicêtre, 94270 Kremlin-Bicêtre, France.
authors.forename: J
authors.initials: J
authors.lastname: Caroff
authors.affiliation: Department of neuroradiology, hôpital Maison-Blanche, université de Champagne-Ardenne, CHU de Reims, 51100 Reims, France.
authors.forename: S
authors.initials: S
authors.lastname: Soize
authors.affiliation: Department of diagnostic and interventional neuroradiology, CHU de Toulouse, 31000 Toulouse, France.
authors.forename: C
authors.initials: C
authors.lastname: Cognard
authors.affiliation: Department of interventional neuroradiology, CHU Kremlin-Bicêtre, 94270 Kremlin-Bicêtre, France.
authors.forename: L
authors.initials: L
authors.lastname: Spelle
authors.affiliation: Department of neuroradiology, Bretonneau hospital, university François-Rabelais, 37000 Tours, France.
authors.forename: D
authors.initials: D
authors.lastname: Herbreteau
mesh_terms: D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D005602:France; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Endovascular treatment; Flow disruption; Intracranial aneurysms; Intrasaccular device; WEB