Abstract Number ‐ 134: How far can we go? WEB technology for the treatment of sidewall IA. Single Institution.

Abstract

Introduction Few years after introduction, Flow disruption technology using WEB device has been used safely for the treatment of wide‐neck bifurcation aneurysms, but the use of this endosaccular approach to treat side‐wall lesions in terms of feasibility, safety, stability and aneurysm occlusion rate after this treatment is unknown. Methods Patients were carefully selected. IRB approved. Clinical, anatomical, angiographical and technical considerations were analyzed. Procedure related complications, procedural time, antiplatelet therapy requirements. Web Occlusion Scale (WOS) was used for the Follow‐up. Results From August 2017 and March 2021 a total of 14 wide‐necked, sidewall, IA were selected for WEB treatment. Aneurysm mean size 5.3mm in width and 5.8 in height. Aneurysm Location: ICA 8 cases (five PComA, two Carotid‐ophtalmic segment, one AChoA segment), Superior Cerebellar Artery SCA in 5 patients (35%), and one impressive case in posterior circulation associated with a basilar fenestration next to VBJ. Eight cases were unruptured (57%), and six cases with history of SAH‐ acute setting. DAPT used pre operatively in all elective cases but none patient remain under antiplatelets after procedure. Technical success of 100%. Mean procedure time: 24 min. None related procedure complications recorded. Immediately angiographic occlusion was evidenced in 9 cases. Radiological Follow up (ranging 1‐ 26 months) available in 9/14 showed a WOS adequate occlusion in all cases. Conclusions In our early experience using WEB device to treat different conditions than bifurcation IA´s, the results showed that endossacular approach was feasible in highly selected patients, safety profile in agreement with previous bifurcation experiences and very effective to treat challenge cases with a high probability of recurrence or therapeutic failure. Larger series and controlled studies are required to expand its indications in a near future.