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1. Patient Preparation
Pre-procedure imaging (DSA, MRI) is used to evaluate the size and anatomy of aneurysms. When necessary, antiplatelet therapy is administered while the patient is under general anesthesia.
Woven EndoBridge
Woven EndoBridge
procedure steps
2. Access to Vascular
A femoral or radial artery puncture is used to insert a catheter, which is then directed into the parent artery that supplies the aneurysm.
3. Navigation of Microcatheters
Under constant fluoroscopic guidance, a microcatheter that is precisely the right size for the WEB device is carefully inserted into the aneurysm sac over a microwire.
4. Choosing and Loading Web Devices
The breadth and height of the aneurysm from 3D angiography are used to determine the WEB device size. It is prepared for deployment after being loaded into the microcatheter.
5. Deployment of Devices
After passing via the microcatheter, the self-expanding braided nitinol mesh WEB device is placed inside the aneurysm sac. It covers the neck and prevents inflow by expanding to fit the walls of the aneurysm.
6. Placement and Modification
In order to properly seal the aneurysm, the operator modifies the device during the "deployment window" so that its base is in the best possible alignment with the aneurysm neck.
7. Last Detachment
The WEB gadget is electrothermally separated from its delivery wire after fluoroscopy confirms ideal location and stability.
8. Post-Deployment Imaging Angiography
Post-Deployment Imaging Angiography is used to evaluate parent vascular patency and occlusion success. It is necessary to drastically cut or stop the aneurysm flow.
9. Hemostasis and Catheter Removal
Hemostasis is obtained at the access site and endovascular devices and catheters are gently removed.
10. Aftercare
Clinical monitoring and imaging follow-ups are used to verify the stability of aneurysm occlusion. Long-term dual antiplatelet medication is avoided or minimized in the majority of cases.
disease treated
Brain Aneurysm
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suitable for
Wide-necked bifurcation intracranial aneurysms (WNBAs)
especially those at important arterial bifurcations such the middle cerebral artery (MCA), anterior communicating artery (ACA), basilar tip, and internal carotid artery terminus, can be treated using the Woven EndoBridge (WEB) device.
Conventional coiling or stent-assisted coiling
Conventional coiling or stent-assisted coiling may be difficult or less successful for both ruptured and unruptured aneurysms.
Aneurysms with a dome width of roughly
Aneurysms with a dome width of roughly 2.5 mm to 10-11 mm can be treated with a variety of sizes of the device.
Situations in which balloon remodeling or further stenting
Situations in which balloon remodeling or further stenting are not required in order to achieve the appropriate flow disruption within the aneurysm sac.
WEB frequently requires less aggressive antiplatelet management
WEB frequently requires less aggressive antiplatelet management than stent-assisted methods, so patients for whom limiting or avoiding long-term antiplatelet medication is recommended.
Complicated aneurysms with anatomical characteristics
that make them unsuitable for conventional coiling, such as those with wide necks or challenging access.
Growing application in treating smaller aneurysms
Growing application in treating smaller aneurysms and increased use for ruptured aneurysms, showing safety and efficacy comparable to standard methods.
benefits
Option with Minimal Invasiveness
Compared to more complicated stent-based procedures, the WEB device improves safety by providing a minimally invasive endovascular treatment tailored for wide-neck bifurcation aneurysms.
Decreased Process Time
Its intrasaccular deployment streamlines the process, potentially reducing procedural problems and cutting down on operating room time.
Prevents Prolonged Antiplatelet Therapy
The WEB device frequently reduces or eliminates the requirement for prolonged dual antiplatelet medication, which is particularly advantageous in cases of ruptured aneurysms, in contrast to stent-assisted coiling.
Rates of Effective Occlusion
According to studies, 54–90% of aneurysm occlusions are successful within a year, and long-term outcomes up to five years later demonstrate progressive thrombosis and minimal recurrence.
Minimal Mortality and Morbidity
Low periprocedural morbidity and mortality are shown by clinical trials and real-world data, and many patients achieve functional independence after treatment.
Relevant to Both Unruptured and Ruptured Aneurysms
At difficult sites such the anterior communicating artery, basilar apex, and MCA bifurcation, the device works well for both ruptured and unruptured aneurysms.
A substitute for surgery
The WEB system increases the number of treatment choices for complicated aneurysms by providing a less invasive alternatives to craniotomy and clipping.
Better Results for Patients
Patients who receive treatment with the WEB device frequently recover more quickly and spend less time in the hospital.
post-treatment recovery
Hospital Stay and Initial Recovery
Due to the minimally invasive nature of the surgery, the majority of patients treated with the WEB device can usually return home the following day if they are stable.
Neurological Monitoring
Following surgery, frequent neurological examinations make sure no new problems develop.
In the weeks that follow, recovery from any pre-existing neurological problems frequently proceeds gradually.
Activity and Follow-Up
Patients should gradually resume their regular routines after first avoiding physically demanding activities.
To determine the status of aneurysm occlusion, follow-up imaging (DSA or MRI) usually takes place three to six months later and again a year later.
Long-Term Results
Research indicates that most patients experience stable or progressive aneurysm occlusion over years with minimal retreatment rates.
In follow-ups, no rebleeding incidents were observed.
Medication
Compared to stent-assisted procedures, antiplatelet therapy needs are typically less stringent, lowering the risk of bleeding problems.
Functional Recovery
With minimal procedure morbidity and mortality, the majority of patients reach neurological baseline and functional independence at follow-up.
Rehabilitation
