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Research ArticleNeurointervention

Endovascular Treatment of Small and Very Small Intracranial Aneurysms with the Woven EndoBridge Device

J.-B. Girot, J. Caroff, J. Cortese, C. Mihalea, A. Rouchaud, V. Da Ros, J.V. Martinez, L. Contreras, L. Ikka, V. Chalumeau, A. Ozanne, G.B.D. Aguiar, S. Gallas, J. Moret and L. Spelle
American Journal of Neuroradiology May 2021, DOI: https://doi.org/10.3174/ajnr.A7115
J.-B. Girot
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
bRadiology Department (J.-B.G.), Angers University Hospital, Angers, France
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J. Caroff
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
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J. Cortese
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
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C. Mihalea
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
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A. Rouchaud
cDepartment of Radiology (A.R.), Centre Hospitalier et Universitaire Dupuytren, Centre National de la Recherche Scientifique, XLIM, Unité Mixte de Recherche Limoges, France
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V. Da Ros
dDepartment of Biomedicine and Prevention (V.D.R.), University Hospital of Rome Tor Vergata, Rome, Italy
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J.V. Martinez
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
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L. Contreras
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
eDepartment of Neurosurgery (L.C.), Hospital Clínico Universidad de Chile, Santiago, Chile
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L. Ikka
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
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V. Chalumeau
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
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A. Ozanne
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
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G.B.D. Aguiar
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
fDepartment of Surgery, Discipline Neurosurgery (G.B.D.A.), Santa Casa de Sao Paulo School of Medical Sciences. São Paulo, Brazil
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S. Gallas
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
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J. Moret
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
gUniversité Paris Sud, faculté de Médecine (J.M., L.S.), Le Kremlin-Bicêtre, France.
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L. Spelle
aDepartment of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France
gUniversité Paris Sud, faculté de Médecine (J.M., L.S.), Le Kremlin-Bicêtre, France.
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Figures

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  • FIG 1.
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    FIG 1.

    Ruptured anterior communicating artery aneurysm treatment using an SL 3.5 × 2 mm WEB. A, Left internal carotid angiogram shows the aneurysm. B, 3D rotational angiography with aneurysm measurement. C, A postdeployment angiogram shows a good filling of the aneurysmal sac with persistent opacification inside the WEB. D and E, Three-month follow-up angiogram shows complete exclusion of the aneurysm. F, Three-month follow-up VasoCT confirms the aneurysm exclusion, with slight WEB compaction.

  • FIG 2.
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    FIG 2.

    Technical failure in a left superior cerebellar artery with an SL 3 × 2 WEB. A, A left vertebral angiogram shows the left cerebellar aneurysm. B, 3D rotational angiography with aneurysm measurement. C, WEB deployment attempt, with the proximal marker (white arrow) protruding into the basilar trunk. D, Final angiogram after coiling. E, Retrospective Sim&Cure simulation showing SL 3 WEB protrusion into the superior cerebellar artery and basilar trunk.

Tables

  • Figures
  • Baseline characteristics and angiographic outcomesa

    Treated Intracranial AneurysmsAll (n = 29)
    Baseline demographic characteristicsAll (n = 27)
    Age (mean) (yr)54 (SD, 11.5)
    Female18 (67)
    Hypertension7 (26)
    Dyslipidemia4 (15)
    Smoking
        Global14 (52)
        Active8 (30)
        History6 (22)
    Baseline aneurysm characteristicsAll (n = 29)
    Aneurysm location
        Middle cerebral artery15 (52)
        Anterior communicating artery8 (28)
        Basilar tip3 (11)
        Carotid tip1 (3)
        Anterior cerebral artery1 (3)
        Posterior communicating artery1 (3)
    Acutely ruptured10 (34)
    Maximum diameter (mean) (mm)3.8 (SD, 0.9)
    Aneurysm height (mean) (mm)2.9 (SD, 0.6)
    Aneurysm width (mean) (mm)2.8 (SD, 0.6)
    Aneurysm neck (mean) (mm)2.6 (SD, 0.5)
    Aspect ratio (height/neck) (mean)1.2 (SD, 0.4)
    Width/neck ratio (mean)1.1 (SD, 0.2)
    Wide neck18 (62)
    Baseline treatment characteristicsAll (n = 29)
        WEB
         SL 317 (59)
         SL 3.59 (31)
    Technical failure3 (10)
    Angiographic outcomesAll (n = 21)
        Adequate occlusion19 (90)
        Complete occlusion15 (71)
        Aneurysm remnant2 (10)
    • ↵a Data are number of subjects (and percentage) for qualitative variables, and mean (and standard deviation) for quantitative variables.

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Cite this article
J.-B. Girot, J. Caroff, J. Cortese, C. Mihalea, A. Rouchaud, V. Da Ros, J.V. Martinez, L. Contreras, L. Ikka, V. Chalumeau, A. Ozanne, G.B.D. Aguiar, S. Gallas, J. Moret, L. Spelle
Endovascular Treatment of Small and Very Small Intracranial Aneurysms with the Woven EndoBridge Device
American Journal of Neuroradiology May 2021, DOI: 10.3174/ajnr.A7115

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Endovascular Treatment of Small and Very Small Intracranial Aneurysms with the Woven EndoBridge Device
J.-B. Girot, J. Caroff, J. Cortese, C. Mihalea, A. Rouchaud, V. Da Ros, J.V. Martinez, L. Contreras, L. Ikka, V. Chalumeau, A. Ozanne, G.B.D. Aguiar, S. Gallas, J. Moret, L. Spelle
American Journal of Neuroradiology May 2021, DOI: 10.3174/ajnr.A7115
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