WovenEndoBridge-assisted coiling: Step-by-step technical insights.

Area of Science:

• Endovascular neurosurgery
• Cerebrovascular disease management

Background:

• Wide-necked bifurcation aneurysms (WNBAs) pose significant treatment challenges.
• The WovenEndoBridge (WEB) device is effective for WNBAs but often insufficient for large aneurysms (≥10 mm).

Purpose of the Study:

• To describe and demonstrate the WEB-assisted coiling technique for treating large ruptured WNBAs.
• To highlight the potential of this technique in acute settings and subsequent elective management.

Main Methods:

• The technique involves deploying the WEB device as a scaffold to facilitate coil embolization of the aneurysm sac.
• A case example details catheterization, WEB deployment, and subsequent coiling of a large basilar tip aneurysm.

Main Results:

• The WEB-assisted coiling technique allows for the treatment of large WNBAs where the WEB device alone may be inadequate.
• This approach simplifies acute treatment without immediate need for neck remodeling or dual anti-aggregation.

Conclusions:

• WEB-assisted coiling is a viable adjunct for treating large ruptured WNBAs, especially when neck anatomy precludes other methods.
• This technique may facilitate elective management with dual anti-aggregation and stenting post-embolization.