Large intracranial aneurysms at a bifurcation of an artery require a gentle yet effective way to stop blood flow into the ballooning volume. A new intrasaccular flow disrupter called WEB from Sequent Medical of Aliso Viejo, California was recently subject to a clinical trial involving 20 patients with unruptured wide-neck bifurcation aneurysms.
The device, though looks like is made of two parts, is a single component made of nitinol and platinum using novel Microbraid technology that allows the creation of three-dimensional objects that exhibit specific mechanical properties. The WEB is suitable for both ruptured and unruptured aneurysms, works with traditional catheters and can be removed post-implantation as necessary. The WEB received the CE Mark in 2010 and is currently being utilized at select clinical centers.
From the abstract in American Journal of Neuroradiology:
RESULTS: Failure of WEB placement occurred in 1 case because of unavailability of a suitably sized device. Embolization was successful in 18 patients with 19 IAs, and it required additional stent placement and/or coiling in 3 cases at the acute phase and in 1 case at follow-up. Two patients experienced a symptomatic complication, and 16 patients had normal neurologic examination findings at discharge. Immediate anatomic outcome showed 1 complete occlusion, 13 near-complete occlusions, and 5 incomplete occlusions. At follow-up, 17 patients had normal neurologic examination findings and 1 retained a hemiparesis. Angiographic controls were obtained in all patients (mean, 6 months), and they showed stable or improved results in all except 4 cases, including 2 complete occlusions, 15 near-complete occlusions, and 2 incomplete occlusions.
CONCLUSIONS: In this initial series of patients, EVT of wide-neck bifurcation IAa with the WEB was feasible. Further studies are needed to evaluate the indications, safety, and efficacy of this new technique.
Here are a couple videos from Sequent about the WEB device:
Product page: WEB Aneurysm Embolization System…
Study in American Journal of Neuroradiology: WEB Device for Endovascular Treatment of Wide-Neck Bifurcation Aneurysms