Basilar artery fenestration aneurysm treated with the Woven EndoBridge device

Abstract

Arterial fenestrations are anomalies in embryonic vascular development and considered rare congenital variations. The management of fenestration aneurysms of the lower third of the basilar artery is challenging because of complex morphology. Given its relationship with the skull base and critical neurovascular structures, endovascular treatment is preferred over microsurgery, and allows the use of a range of different endovascular devices and techniques. The Woven EndoBridge (WEB) device was specifically developed for treating wide-neck aneurysms in arterial bifurcations and is a self-expanding braided mesh of nitinol with platinum core. The devicés dense metal mesh disrupts intra-aneurysmal blood flow and promotes intrassacular thrombosis, while the mesh and neck together create a surface favorable to neo-endothelialization. The WEB allows solely endosaccular treatment, without the need for further implants in the lumen of parent vessels, thereby reducing the risk of complications and dispensing with the need for antiplatelet therapy. The present study reports the successful treatment of a basilar artery fenestration aneurysm using the WEB device.