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Snare salvage technique for deformed WEB device after deployment.

Zaid Aljuboori1, Dale Ding2, Robert F James3

  • 1Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA zaid.aljuboori@yahoo.com rfjames@iu.edu.

Journal of Neurointerventional Surgery
|September 9, 2020
PubMed
Summary

A novel endovascular technique successfully restored the shape of a deformed Woven EndoBridge (WEB) device during aneurysm treatment. This case highlights a method to salvage WEB device deployment errors, ensuring effective aneurysm occlusion.

Keywords:
aneurysmarterydevice

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Area of Science:

  • Endovascular neurosurgery
  • Medical device technology
  • Cerebrovascular disease management

Background:

  • Wide-neck bifurcation aneurysms pose treatment challenges.
  • The Woven EndoBridge (WEB) device offers an alternative to dual antiplatelet therapy.
  • Patient presented with a right middle cerebral artery bifurcation aneurysm while on warfarin therapy.

Observation:

  • A WEB SL device was deployed for aneurysm treatment.
  • A technical error caused device deformation, leaving the aneurysm partially untreated.
  • An Amplatz Goose Neck Microsnare was used to recapture and reshape the device.

Findings:

  • Gentle traction with the Microsnare successfully restored the WEB device's original shape.
  • The repositioned device achieved a similar result to the intended deployment.
  • Follow-up angiography at 4 months confirmed sustained device shape and aneurysm treatment.

Implications:

  • This technique offers a potential salvage strategy for WEB device deployment errors.
  • It may prevent the need for re-intervention in complex aneurysm cases.
  • Successful reshaping ensures effective aneurysm occlusion and patient safety.