Abstract:

Objective: To preliminarily explore the efficacy and safety of the Woven EndoBridge (WEB) device in the treatment of intracranial bifurcation wide-neck aneurysms. Methods: A retrospective analysis was conducted on the clinical data of 12 patients with intracranial bifurcation wide-neck aneurysms treated with the WEB device in Ruijin Hospital, Shanghai Jiaotong University School of Medicine between January and June 2024. The aneurysms were located at the bifurcation of middle cerebral artery (MCA) in 7 cases, the apex of basilar artery (BA) in 4 cases, and the anterior communicating artery complex (ACoAC) in one case. Neurological functional prognosis was assessed at discharge using the modified Rankin Scale (mRS), and complications occurring immediately after operation, within 24-48 h postoperatively, during hospitalization, and at 30 d postoperatively were recorded. Results: A total of 12 aneurysms in 12 patients were included. Preoperatively, 11 cases were unruptured aneurysms (mRS scores of 0), and one case was a ruptured aneurysm (mRS score of 1). All 12 patients underwent treatment with a single WEB device, which was successfully delivered and deployed in one attempt, achieving a technical success rate of 12/12. At discharge, 11 cases had an mRS score of 0, and one case had a score of 1. Immediately postoperative CT revealed no evidence of new cerebral ischemia or hemorrhage. No new intracranial hemorrhage, subarachnoid hemorrhage (SAH), or new cerebral infarction related to the aneurysm was observed within 24- 48 h postoperatively, and no complications such as puncture site bleeding occurred during hospitalization. At 30 d postoperatively, there were no neurological ischemic or hemorrhagic adverse events and complications such as puncture site bleeding. Conclusions: Preliminary findings suggest that the WEB device is safe and effective for treating intracranial bifurcation wide-neck aneurysms.

Key words: Intracranial aneurysm, Middle cerebral artery, Basilar artery, Circle of Willis, Embolization, therapeutic

摘要：

目的: 初步探讨瘤内扰流装置WEB治疗颅内分叉部宽颈动脉瘤的有效性及安全性。方法: 回顾分析2024年1-6月上海交通大学医学院附属瑞金医院应用WEB装置行血管内治疗的12例颅内分叉部宽颈动脉瘤患者的临床经过，动脉瘤位于大脑中动脉分叉部7例、基底动脉顶端4例、前交通动脉复合体1例。出院时采用改良Rankin量表（mRS）评估神经功能预后，记录术后即刻、术后24~48 h、住院期间及术后30 d并发症发生率。结果: 共12例患者计12个动脉瘤，11例为未破裂动脉瘤（术前mRS评分为零），1例为破裂动脉瘤（术前mRS评分为1分），均采取单一WEB装置治疗，一次性成功输送并释放，技术成功率达12/12。出院时11例mRS评分为零（均为未破裂动脉瘤患者），1例为1分（破裂动脉瘤患者）。术后即刻未见新发脑缺血或脑出血，术后24~48 h未见新发脑实质出血、蛛网膜下腔出血及动脉瘤相关新发脑梗死，住院期间无穿刺点出血等并发症，术后30 d亦无缺血性或出血性不良事件及穿刺点出血等并发症。结论: 初步认为WEB装置治疗颅内分叉部宽颈动脉瘤安全、有效。

关键词: 颅内动脉瘤, 大脑中动脉, 基底动脉, 大脑动脉环, 栓塞，治疗性