Experience of WEB embolization device implantation for treatment of intracranial arterial aneurisms

Abstract

For the first time in Ukraine, Woven EndoBridge (WEB) (Microvention – Terumo) for the treatment of intracranial arterial aneurysms was applied at Scientific and Practical Centre of Endovascular Neuroradiology of NAMS of Ukraine on November 29, 2018. To the end of 2019 4 patients were treated with WEB. In all patients aneurysms were accidental findings, diagnosed by magnetic resonance imaging, and confirmed by angio-graphy. Men were 2 (50 %), women – 2 (50 %). The average age of patients was 49 years. All aneurysms were complex for endovascular treatment. In 3 (75 %) cases, the aneurysm was located on the anterior cerebral/anterior connective arteries, in 1 (25 %) case – on the middle cerebral artery. All patients received double disaggregated therapy at the standard dosage (75 mg of clopidogrel and 75 mg of acetylsalicylic acid) during 5 days before surgery in case of an additional intracranial stent implantation. The efficacy of dual disaggregation therapy was monitored by light transmission agrigometry. The size of the WEB depended on the angioarchitectonics of the aneurysm. All surgeries were performed in a routine manner, under general anesthesia. In all cases, the WEB was implanted successfully, there were no intra- and postoperative complications. The next day after surgery, double disaggregation therapy was canceled. All patients were discharged from the hospital in satisfactory condition, under the supervision of a neurologist at the place of residence. A control examination in the form of angiography after 6 months passed all patients. The efficacy of aneurysm occlusion using the WEB embolization device was evaluated on the WEB occlusion scale. Grade 0 and 0’ were achieved in 2 (50 %) patients, Grade 1 – 1 (25 %), Grade 2 – 1 (25 %).