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Off-Label Use of the WEB Device.

Publication ,  Journal Article
Zanaty, M; Roa, JA; Tjoumakaris, SI; Jabbour, P; Mouchtouris, N; Sweid, A; Ortega-Gutierrez, S; Ishii, D; Limaye, K; Asi, K; Samaniego, EA; Hasan, DM
Published in: World Neurosurg
February 2020

OBJECTIVE: We present our initial experience with the off-label use of the Woven EndoBridge (WEB) device. METHODS: We performed a retrospective study from 2 institutions of patients with intracranial aneurysms who underwent treatment with the WEB device alone or in conjunction with stenting and/or coiling in an off-labeled location. RESULTS: Eleven patients with 12 aneurysms were included. Four (30.8%) aneurysms presented ruptured. Off-labeled locations included 3 aneurysms in the posterior communicating artery, 3 in the supraclinoid ophthalmic artery, 2 in the pericallosal artery, 2 in the posterior inferior cerebellar artery, 1 at the vertebrobasilar junction, and 1 in the cavernous internal carotid artery. Mean dome-to-neck ratio was 1.91 ± 0.9. Average duration of the procedure was 63.9 ± 29.6 minutes. Femoral route was used in 61.5%, and radial access in 48.5% of cases. Five procedures (41.7%) were performed under monitored anesthesia care. We had 1.33 attempts per aneurysm. WEB embolization was supplemented with coiling in 2 cases (16.67%) and stenting in 1 case (8.3%). Based on the O'Kelly-Marotta ("OKM") grading scale, we report a rate of 0% for grade 1, 33.3% for grade 2, and 33.3% for grade 3. Postprocedural occlusion was complete in 4 (33.3%) and adequate in 8 (66.6%) patients. No procedure-related deaths or symptomatic complications were reported. CONCLUSIONS: The WEB device was successfully deployed in off-labeled locations, including posterior communicating artery, ophthalmic artery, and pericallosal aneurysms. The efficacy of this usage must be evaluated in multicenter prospective studies, but our preliminary results are promising. Correct characterization of the aneurysm size/morphology, as well as awareness of possible adjunct treatments, are crucial for successful intervention.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

February 2020

Volume

134

Start / End Page

e1047 / e1052

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Prostheses and Implants
  • Ophthalmic Artery
  • Off-Label Use
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans
  • Female
 

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Zanaty, M., Roa, J. A., Tjoumakaris, S. I., Jabbour, P., Mouchtouris, N., Sweid, A., … Hasan, D. M. (2020). Off-Label Use of the WEB Device. World Neurosurg, 134, e1047–e1052. https://doi.org/10.1016/j.wneu.2019.11.076
Zanaty, Mario, Jorge A. Roa, Stavropoula I. Tjoumakaris, Pascal Jabbour, Nikolaos Mouchtouris, Ahmad Sweid, Santiago Ortega-Gutierrez, et al. “Off-Label Use of the WEB Device.World Neurosurg 134 (February 2020): e1047–52. https://doi.org/10.1016/j.wneu.2019.11.076.
Zanaty M, Roa JA, Tjoumakaris SI, Jabbour P, Mouchtouris N, Sweid A, et al. Off-Label Use of the WEB Device. World Neurosurg. 2020 Feb;134:e1047–52.
Zanaty, Mario, et al. “Off-Label Use of the WEB Device.World Neurosurg, vol. 134, Feb. 2020, pp. e1047–52. Pubmed, doi:10.1016/j.wneu.2019.11.076.
Zanaty M, Roa JA, Tjoumakaris SI, Jabbour P, Mouchtouris N, Sweid A, Ortega-Gutierrez S, Ishii D, Limaye K, Asi K, Samaniego EA, Hasan DM. Off-Label Use of the WEB Device. World Neurosurg. 2020 Feb;134:e1047–e1052.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

February 2020

Volume

134

Start / End Page

e1047 / e1052

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Prostheses and Implants
  • Ophthalmic Artery
  • Off-Label Use
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans
  • Female