Endovascular Treatment of Small and Very Small Intracranial Aneurysms with the Woven EndoBridge Device.

Blood Vessel Prosthesis Embolization, Therapeutic Endovascular Procedures Female Humans Intracranial Aneurysm / diagnostic imaging Male Middle Aged Retrospective Studies Treatment Outcome

Journal

AJNR. American journal of neuroradiology
ISSN: 1936-959X
Titre abrégé: AJNR Am J Neuroradiol
Pays: United States
ID NLM: 8003708

Informations de publication

Date de publication:
07 2021
Historique:
received: 19 11 2020
accepted: 11 01 2021
pubmed: 1 5 2021
medline: 13 10 2021
entrez: 30 4 2021
Statut: ppublish

Résumé

The Woven EndoBridge has proved to be a safe and effective treatment, especially for wide-neck intracranial aneurysms. The recent fifth-generation Woven EndoBridge came with smaller devices. The purpose of this study was to assess the safety and efficiency of Woven EndoBridge treatment of small and very small aneurysms. Between September 2017 and March 2020, all consecutive patients treated with a 3- or 3.5 mm-width Woven EndoBridge device were included in this retrospective intention-to-treat study. Clinical and radiologic findings were evaluated at immediate and last-available follow-up. Angiographic outcome was assessed by an external expert reader. One hundred twenty-eight aneurysms were treated with a fifth-generation Woven EndoBridge device including 29 with a width of ≤3.5 mm. Ten aneurysms were ruptured (34%). In 3 cases (10%), Woven EndoBridge treatment could not be performed because the aneurysm was still too small for the smallest available Woven EndoBridge device and another endovascular strategy was chosen. The median follow-up time was 11.2 months. Complete and adequate occlusion was obtained in 71% and 90% of the treated aneurysms, respectively. Retreatment was needed in 2 cases (10%). Symptomatic ischemic complications leading to transient neurologic deficits occurred in 2 cases (7%) (1 procedure-related and 1 device-related) but with full spontaneous recovery at discharge. The fifth-generation Woven EndoBridge device seems to be a safe and technically feasible treatment for both ruptured and unruptured small and very small intracranial aneurysms, with satisfactory occlusion rates on midterm follow-up. However, further study is needed to evaluate longer-term efficiency.

Sections du résumé

BACKGROUND AND PURPOSE
The Woven EndoBridge has proved to be a safe and effective treatment, especially for wide-neck intracranial aneurysms. The recent fifth-generation Woven EndoBridge came with smaller devices. The purpose of this study was to assess the safety and efficiency of Woven EndoBridge treatment of small and very small aneurysms.
MATERIALS AND METHODS
Between September 2017 and March 2020, all consecutive patients treated with a 3- or 3.5 mm-width Woven EndoBridge device were included in this retrospective intention-to-treat study. Clinical and radiologic findings were evaluated at immediate and last-available follow-up. Angiographic outcome was assessed by an external expert reader.
RESULTS
One hundred twenty-eight aneurysms were treated with a fifth-generation Woven EndoBridge device including 29 with a width of ≤3.5 mm. Ten aneurysms were ruptured (34%). In 3 cases (10%), Woven EndoBridge treatment could not be performed because the aneurysm was still too small for the smallest available Woven EndoBridge device and another endovascular strategy was chosen. The median follow-up time was 11.2 months. Complete and adequate occlusion was obtained in 71% and 90% of the treated aneurysms, respectively. Retreatment was needed in 2 cases (10%). Symptomatic ischemic complications leading to transient neurologic deficits occurred in 2 cases (7%) (1 procedure-related and 1 device-related) but with full spontaneous recovery at discharge.
CONCLUSIONS
The fifth-generation Woven EndoBridge device seems to be a safe and technically feasible treatment for both ruptured and unruptured small and very small intracranial aneurysms, with satisfactory occlusion rates on midterm follow-up. However, further study is needed to evaluate longer-term efficiency.

Identifiants

DOI: 10.3174/ajnr.A7115 PMID: 33926902 PMC: PMC8324278
pubmed: 33926902
pii: ajnr.A7115
doi: 10.3174/ajnr.A7115
pmc: PMC8324278
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1276-1281

Informations de copyright

© 2021 by American Journal of Neuroradiology.

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Auteurs

J-B Girot (JB)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
Radiology Department (J.-B.G.), Angers University Hospital, Angers, France.
ORCID: 0000-0002-2780-6907

J Caroff (J)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France Jildaz.caroff@aphp.fr.
ORCID: 0000-0002-0029-1835

J Cortese (J)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
ORCID: 0000-0002-1616-9113

C Mihalea (C)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
ORCID: 0000-0002-8260-8284

A Rouchaud (A)

Department of Radiology (A.R.), Centre Hospitalier et Universitaire Dupuytren, Centre National de la Recherche Scientifique, XLIM, Unité Mixte de Recherche Limoges, France.
ORCID: 0000-0003-0902-3375

V Da Ros (VD)

Department of Biomedicine and Prevention (V.D.R.), University Hospital of Rome Tor Vergata, Rome, Italy.
ORCID: 0000-0001-7167-7594

J V Martinez (JV)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
ORCID: 0000-0002-4987-1419

L Contreras (L)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
Department of Neurosurgery (L.C.), Hospital Clínico Universidad de Chile, Santiago, Chile.
ORCID: 0000-0003-4928-4545

L Ikka (L)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
ORCID: 0000-0002-6739-3692

V Chalumeau (V)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
ORCID: 0000-0002-7753-7186

A Ozanne (A)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
ORCID: 0000-0002-2730-6400

G B D Aguiar (GBD)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
Department of Surgery, Discipline Neurosurgery (G.B.D.A.), Santa Casa de Sao Paulo School of Medical Sciences. São Paulo, Brazil.
ORCID: 0000-0003-3206-2081

S Gallas (S)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
ORCID: 0000-0002-7189-8888

J Moret (J)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
Université Paris Sud, faculté de Médecine (J.M., L.S.), Le Kremlin-Bicêtre, France.
ORCID: 0000-0002-2086-2973

L Spelle (L)

From the Department of Interventional Neuroradiology-NEURI Brain Vascular Center (J.-B.G., J. Caroff, J. Cortese, C.M., J.V.M., L.C., L.I., V.C., A.O., G.B.D.A., S.G., J.M., LS.), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
Université Paris Sud, faculté de Médecine (J.M., L.S.), Le Kremlin-Bicêtre, France.
ORCID: 0000-0002-6748-8528

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Classifications MeSH

questionsmedicales.fr › Équipement et fournitures › Prothèses et implants › Prothèse vasculaire › Endovascular Treatment of Small and Very Small...
questionsmedicales.fr › Thérapeutique › Occlusion thérapeutique › Embolisation thérapeutique › Endovascular Treatment of Small and Very Small...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Procédures endovasculaires › Endovascular Treatment of Small and Very Small...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Endovascular Treatment of Small and Very Small...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Artériopathies intracrâniennes › Anévrysme intracrânien › Endovascular Treatment of Small and Very Small...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Endovascular Treatment of Small and Very Small...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Endovascular Treatment of Small and Very Small...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Endovascular Treatment of Small and Very Small...