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Aneurysm clipping on WEB device: A feasibility study using a human ex-vivo aneurysm model.
Salvador F Gutierrez-Aguirre1, Otavio F De Toledo1, Victor H C Benalia2
1Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, FL, USA; Research Department, Jacksonville University, Jacksonville, FL, USA.
Clinical Neurology and Neurosurgery
|December 7, 2024
Summary
Microsurgical clipping effectively collapses the Woven EndoBridge (WEB) device in aneurysms, regardless of clip angle. This technique shows promise for treating recurrences after WEB treatment, though WEB shape changes are possible.
Area of Science:
- Neurosurgery
- Interventional Neuroradiology
- Biomedical Engineering
Background:
- The Woven EndoBridge (WEB) device is a key treatment for complex brain aneurysms.
- Aneurysm recurrence after WEB treatment can occur.
- The effect of clipping angle on WEB mesh collapse is not well understood.
Purpose of the Study:
- To investigate the technical aspects of applying microsurgical clips to WEB-treated aneurysms.
- To determine the influence of clipping angle on WEB mesh collapse in an ex-vivo model.
Main Methods:
- A human placenta-based ex-vivo aneurysm model was utilized.
- WEB devices were deployed in simulated aneurysms.
- Different clip positions and angles were tested on the WEB device.
Main Results:
- All clipping methods achieved complete aneurysm occlusion.
- The WEB mesh was effectively collapsed with no observed intra-aneurysmal flow.
- No significant aneurysm morphological changes were noted, irrespective of WEB displacement.
Conclusions:
- Microsurgical clipping reliably collapses the WEB device, irrespective of clip placement or orientation.
- Clipping may be an effective strategy for managing in-vivo recurrences or persistent filling post-WEB treatment.
- Awareness of potential WEB shape changes during clipping is important for operators.
