Universität zu Köln

Kabbasch, Christoph, Goertz, Lukas, Siebert, Eberhard, Herzberg, Moriz, Hamisch, Christina, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164, Dorn, Franziska ORCID: 0000-0001-9093-8307 and Liebig, Thomas (2019). Treatment strategies for recurrent and residual aneurysms after Woven Endobridge implantation. J. NeuroInterventional Surg., 11 (4). S. 390 - 397. LONDON: BMJ PUBLISHING GROUP. ISSN 1759-8486

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Abstract

Background Woven Endobridge (WEB) embolization is a safe and efficient technique for endovascular treatment of intracranial aneurysms. However, the management of aneurysm recurrence after WEB placement has not been well described to date. We present our multicenter experience of endovascular retreatment of aneurysm recurrence after WEB implantation. Methods This is a multicenter study of patients who underwent endovascular retreatment after WEB implantation in three German tertiary care centers. Treatment strategies, complications, and angiographic outcome were retrospectively assessed. Results A mong 122 aneurysms treated with the WEB device, 15 were retreated. Of these, six were initially treated with the WEB only, two were pretreated by coiling, and seven large aneurysms were treated in a multimodality approach. Ten were true aneurysm remnants and five were neck remnants. The reasons for retreatment were WEB migration (n=6), initial incomplete occlusion (n=5), and WEB compression (n=4). Retreatment strategies included coiling (n=4), stent-assisted coiling (n=7), flow diversion (n=3), and placement of an additional WEB (n=1). All procedures were technically successful and there were no procedure-related complications. Among 11 patients available for follow-up after retreatment, three were retreated again. At last angiographic follow-up, available in 11/15 cases at a median of 23 months, complete occlusion was obtained in eight cases and neck remnants in three. Conclusions This pilot study shows that endovascular retreatment of recurrent or residual aneurysms after WEB implantation can be done safely and can achieve adequate occlusion rates.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebert, Eberhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Herzberg, Moriz UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamisch, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED Dorn, Franziska UNSPECIFIED orcid.org/0000-0001-9093-8307 UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-151343
DOI:	10.1136/neurintsurg-2018-014230
Journal or Publication Title:	J. NeuroInterventional Surg.
Volume:	11
Number:	4
Page Range:	S. 390 - 397
Date:	2019
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1759-8486
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language THROMBOSED INTRACRANIAL ANEURYSMS; CEREBRAL ANEURYSMS; EMBOLIZATION DEVICE; COIL EMBOLIZATION; WEB; SAFETY; RETREATMENT; RISK Multiple languages Neuroimaging; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15134