Abstract W P80: Wide Neck Cerebral Bifurcation Aneurysms Treated With Web Device. A Single Center Experience of a New Treatment Modality

Introduction: WEB is a new endosaccular device for treatment of wide neck bifurcation cerebral aneurysms(WNBA). we present a single center experience of 17 cases. Purpose: The 17 cases with WNBA were treated in acute or cold situation. Results: Patients ages range from 43 to 71. 4 cases were treated in the acute phase (<24h), 13 were incidental. The size ranges from 5 to 11 mm. 4 cases were basilar aneurysms, 11 were MCA aneurysms and 2 were Acom aneurysms. All patients with an incidental aneurysm were premedicated with Plavix and Aspirin. The acute patients had only Aspirin IV and systemic heparin during the treatment. Except one patient (the first case), all the other had a successful treatment. Up to now we have not had any complication to deplore. The long term anatomical results (according to the Raymond scale) are: 11 patients had 3 to 11 months follow-up. Among those patients 9 were classified A, and 2 B. Discussion: Considering the difficult anatomy of most of the aneurysms, one can say that technically, the delivery of the device is reliable and safe. However the visibility of the WEB is poor and needs VasoCT or a DynaCT to control otherwise the risk of a wrong positioning is too high and should not be taken. Each time we had to change the size of the device during the treatment it was possible, however the larger the device, the more difficult the withdrawal. In all cases, the time of the procedure was short (average of 30') and frequently equal to the imaging process after treatment to be sure of the right positioning of the WEB. Even weird shape of the aneurysm appears to be not too much a problem. Conclusions: The WEB brings a new technical solution to WNBA treatment. The tremendous advantage compared to Y stenting and coiling is the possibility to treat in the acute phase. The other advantage is related to the fact that, no device is left in the parent artery. The length of the procedure is incredibly short even if we add the screening post treatment. The preliminary results are promising but need more experience.