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Optimal Woven EndoBridge (WEB) Device Size Selection Using Automated Volumetric Software.

Sameer Ansari1, Cynthia B Zevallos1, Mudassir Farooqui1

  • 1Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.

Brain Sciences
|August 6, 2021
PubMed
Summary

Accurate Woven EndoBridge (WEB) device sizing for wide-neck bifurcation aneurysms is crucial. Automated 3D imaging best predicts WEB device size, improving implantation success rates.

Keywords:
WEB deviceWoven EndoBridgeaneurysmembolizationendovascular

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Area of Science:

  • Neurosurgery
  • Interventional Neuroradiology
  • Medical Imaging

Background:

  • Selecting appropriate Woven EndoBridge (WEB) device size for wide-neck bifurcation aneurysms (WNBAs) presents a significant challenge.
  • Accurate sizing is critical for successful WEB device implantation and optimal patient outcomes.

Purpose of the Study:

  • To evaluate volumetric imaging methodologies for predicting accurate WEB device size selection in WNBAs.
  • To determine the optimal device-aneurysm volume (DAV) ratio for successful WEB implantation.

Main Methods:

  • Retrospective analysis of patients treated with WEB devices for intracranial aneurysms (January 2019 - June 2020).
  • Aneurysm volumes were measured using automated 3D DSA, manual 3D DSA, and 2D DSA.
  • Device-aneurysm volume (DAV) ratio calculated to assess implantation success and 6-month angiographic outcomes.

Main Results:

  • Automated 3D DSA showed the highest correlation (r=0.943) between WEB device and aneurysm volumes.
  • Significant volume differences were observed between automated 3D DSA and 2D DSA (p=0.017).
  • The highest successful implantation rate (87.5%) was achieved with a DAV ratio between 0.6 and 0.8.

Conclusions:

  • Pre-procedural DAV ratio assessment can enhance WEB device implantation success.
  • Volumetric measurements, particularly automated 3D aneurysm volumes, aid in accurate WEB device selection for WNBAs.