Journal article
Off-Label Use of the WEB Device
World neurosurgery, Vol.134, pp.e1047-e1052
02/2020
DOI: 10.1016/j.wneu.2019.11.076
PMID: 31759154
Abstract
We present our initial experience with the off-label use of the Woven EndoBridge (WEB) device.\nWe performed a retrospective study from 2 institutions of patients with intracranial aneurysms who underwent treatment with the WEB device alone or in conjunction with stenting and/or coiling in an off-labeled location.\nEleven patients with 12 aneurysms were included. Four (30.8%) aneurysms presented ruptured. Off-labeled locations included 3 aneurysms in the posterior communicating artery, 3 in the supraclinoid ophthalmic artery, 2 in the pericallosal artery, 2 in the posterior inferior cerebellar artery, 1 at the vertebrobasilar junction, and 1 in the cavernous internal carotid artery. Mean dome-to-neck ratio was 1.91 ± 0.9. Average duration of the procedure was 63.9 ± 29.6 minutes. Femoral route was used in 61.5%, and radial access in 48.5% of cases. Five procedures (41.7%) were performed under monitored anesthesia care. We had 1.33 attempts per aneurysm. WEB embolization was supplemented with coiling in 2 cases (16.67%) and stenting in 1 case (8.3%). Based on the O'Kelly-Marotta (“OKM”) grading scale, we report a rate of 0% for grade 1, 33.3% for grade 2, and 33.3% for grade 3. Postprocedural occlusion was complete in 4 (33.3%) and adequate in 8 (66.6%) patients. No procedure-related deaths or symptomatic complications were reported.\nThe WEB device was successfully deployed in off-labeled locations, including posterior communicating artery, ophthalmic artery, and pericallosal aneurysms. The efficacy of this usage must be evaluated in multicenter prospective studies, but our preliminary results are promising. Correct characterization of the aneurysm size/morphology, as well as awareness of possible adjunct treatments, are crucial for successful intervention.
Details
- Title: Subtitle
- Off-Label Use of the WEB Device
- Creators
- Mario Zanaty - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAJorge A Roa - Department of Neurology and Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAStavropoula I Tjoumakaris - Department of Neurosurgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USAPascal Jabbour - Department of Neurosurgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USANikolaos Mouchtouris - Department of Neurosurgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USAAhmad Sweid - Department of Neurosurgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USASantiago Ortega-Gutierrez - Department of Neurology, Neurosurgery and Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USADaizo Ishii - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAKaustubh Limaye - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAKhaled Asi - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAEdgar A Samaniego - Department of Neurology, Neurosurgery and Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USADavid M Hasan - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- World neurosurgery, Vol.134, pp.e1047-e1052
- DOI
- 10.1016/j.wneu.2019.11.076
- PMID
- 31759154
- NLM abbreviation
- World Neurosurg
- ISSN
- 1878-8750
- eISSN
- 1878-8769
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 02/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984070413502771
Metrics
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