I could see this used instead of coiling for aneurysms, but since I'm not medically trained that is a question for your doctor.
There are some possible risks associated with endovascular coiling. These can include injury or damage to the artery or aneurysm being treated; in rare cases, the aneurysm can rupture. Vasospasm, or a sudden narrowing of the artery, can occur and lead to decreased blood flow to the brain which is fed by that artery. A blood clot can form on the catheter, the coils as they are injected, or in the artery where the catheter is fed. If this occurs, the clot can cause blockage of blood flow or a stroke. The coils may not stay in place or may not completely occlude the aneurysm; if this occurs, the aneurysm might regrow or get larger. Patients may have an allergic reaction to the dye used during the procedure. With any procedure, there is a risk of infection.
Treatment of ruptured intracranial aneurysms with the Woven EndoBridge device: a systematic review
Abstract
The Woven EndoBridge (WEB) device is a barrel-shaped nitinol mesh deployed within the aneurysmal sac. The absence of metallic mesh in the aneurysm’s parent vessel lumen obviates the need for potent antiplatelet therapy, making this device appealing for acutely ruptured aneurysms not amenable to clipping or coiling. To assess the literature regarding WEB treatment of these aneurysms, we performed a comprehensive systematic search of PubMed, MEDLINE, and EMBASE databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Keywords were combined with Boolean operators to increase search sensitivity and specificity (‘woven endobridge device’ AND ‘ruptured’). Nine studies comprising 377 acutely ruptured aneurysms were included. Overall, 82.7% were wide-necked, 85.9% were located in the anterior circulation, and 26.9% of patients presented with poor subarachnoid hemorrhage grade. Intraprocedure and postprocedure complications occurred in 8.4% (95% CI 3.6% to 13.3%) and 1% (95% CI 0% to 2%), respectively. The post-treatment rebleeding rate was 0%. Rates of adequate occlusion (complete occlusion to neck remnant) and retreatment at last follow-up were 84.8% (95% CI 73% to 96.6%) and 4.5% (95% CI 2.2% to 6.8%), respectively. The favorable outcome rate (modified Rankin Scale score 0–2) was 62.2% (95% CI 53% to 71.4%); mortality was 13.6% (95% CI 9.7% to 17.6%). WEB treatment of acutely ruptured aneurysms results in high adequate occlusion rates, low perioperative complication rates, no rebleeding, and low recurrence requiring retreatment. This device is promising for acutely ruptured aneurysms not amenable to clipping or coiling, considering the lower need for antiplatelet regimens during the procedure or follow-up.
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