{"title":"Woven EndoBridge (WEB) 装置脱落后血管内机械阻塞的抢救技术。","authors":"Haoyu Zhu, Yupeng Zhang, Shikai Liang, Chuhan Jiang","doi":"10.1136/jnis-2024-022430","DOIUrl":null,"url":null,"abstract":"<p><p>The Woven EndoBridge (WEB) device is a well established treatment for bifurcation aneurysms.1-6 However, failed detachment after deployment can present significant challenges. In this technical video (video 1), we report on a patient with a left middle cerebral artery (MCA) bifurcation aneurysm treated with the WEB device. Despite satisfactory deployment, multiple detachment attempts were unsuccessful. After repeated maneuvers, the WEB was finally detached but slightly protruded from the aneurysm sac, compromising blood flow in the superior branch of the MCA. Even after placing an Atlas stent, blood flow was not restored. Ultimately, using a microguidewire and microcatheter, we repositioned the protruded WEB device back into the aneurysm sac, successfully restoring blood flow. This case illustrates that the Atlas stent provides limited support for the WEB device. In similar situations, gently repositioning the protruded WEB back into the aneurysm sac may be a remedial measure. neurintsurg;jnis-2024-022430v1/V1F1V1Video 1Technical video demonstrating rescue techniques for managing intravascular mechanical obstruction following detachment of the WEB device.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Rescue techniques for intravascular mechanical obstruction following Woven EndoBridge (WEB) device detachment.\",\"authors\":\"Haoyu Zhu, Yupeng Zhang, Shikai Liang, Chuhan Jiang\",\"doi\":\"10.1136/jnis-2024-022430\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The Woven EndoBridge (WEB) device is a well established treatment for bifurcation aneurysms.1-6 However, failed detachment after deployment can present significant challenges. In this technical video (video 1), we report on a patient with a left middle cerebral artery (MCA) bifurcation aneurysm treated with the WEB device. Despite satisfactory deployment, multiple detachment attempts were unsuccessful. After repeated maneuvers, the WEB was finally detached but slightly protruded from the aneurysm sac, compromising blood flow in the superior branch of the MCA. Even after placing an Atlas stent, blood flow was not restored. Ultimately, using a microguidewire and microcatheter, we repositioned the protruded WEB device back into the aneurysm sac, successfully restoring blood flow. This case illustrates that the Atlas stent provides limited support for the WEB device. In similar situations, gently repositioning the protruded WEB back into the aneurysm sac may be a remedial measure. neurintsurg;jnis-2024-022430v1/V1F1V1Video 1Technical video demonstrating rescue techniques for managing intravascular mechanical obstruction following detachment of the WEB device.</p>\",\"PeriodicalId\":16411,\"journal\":{\"name\":\"Journal of NeuroInterventional Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2024-10-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of NeuroInterventional Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/jnis-2024-022430\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NEUROIMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of NeuroInterventional Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/jnis-2024-022430","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NEUROIMAGING","Score":null,"Total":0}
引用次数: 0
摘要
Woven EndoBridge（WEB）装置是一种治疗分叉动脉瘤的成熟疗法。在这段技术视频（视频 1）中，我们报告了一名使用 WEB 装置治疗左侧大脑中动脉 (MCA) 分叉动脉瘤的患者。尽管部署效果令人满意，但多次剥离尝试均未成功。经过反复操作，WEB 最终被分离，但略微突出于动脉瘤囊，影响了 MCA 上支的血流。即使放置了阿特拉斯支架，血流也没有恢复。最终，我们使用微导管和微导管将突出的 WEB 装置重新植入动脉瘤囊，成功恢复了血流。该病例说明，Atlas 支架对 WEB 装置的支撑作用有限。在类似情况下，将突出的 WEB 轻轻地重新置入动脉瘤囊可能是一种补救措施。 neurintsurg;jnis-2024-022430v1/V1F1V1V1 视频 1Technical video demonstrating rescue techniques for managing intravascular mechanical obstruction following detachment of the WEB device.
Rescue techniques for intravascular mechanical obstruction following Woven EndoBridge (WEB) device detachment.
The Woven EndoBridge (WEB) device is a well established treatment for bifurcation aneurysms.1-6 However, failed detachment after deployment can present significant challenges. In this technical video (video 1), we report on a patient with a left middle cerebral artery (MCA) bifurcation aneurysm treated with the WEB device. Despite satisfactory deployment, multiple detachment attempts were unsuccessful. After repeated maneuvers, the WEB was finally detached but slightly protruded from the aneurysm sac, compromising blood flow in the superior branch of the MCA. Even after placing an Atlas stent, blood flow was not restored. Ultimately, using a microguidewire and microcatheter, we repositioned the protruded WEB device back into the aneurysm sac, successfully restoring blood flow. This case illustrates that the Atlas stent provides limited support for the WEB device. In similar situations, gently repositioning the protruded WEB back into the aneurysm sac may be a remedial measure. neurintsurg;jnis-2024-022430v1/V1F1V1Video 1Technical video demonstrating rescue techniques for managing intravascular mechanical obstruction following detachment of the WEB device.
期刊介绍：
The Journal of NeuroInterventional Surgery (JNIS) is a leading peer review journal for scientific research and literature pertaining to the field of neurointerventional surgery. The journal launch follows growing professional interest in neurointerventional techniques for the treatment of a range of neurological and vascular problems including stroke, aneurysms, brain tumors, and spinal compression.The journal is owned by SNIS and is also the official journal of the Interventional Chapter of the Australian and New Zealand Society of Neuroradiology (ANZSNR), the Canadian Interventional Neuro Group, the Hong Kong Neurological Society (HKNS) and the Neuroradiological Society of Taiwan.
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