Persistent contrast-filling in the woven endobridge device three months after its implantation for cerebral aneurysm: Incidence, predictive factors, and outcome

• Published in: Clinical neurology and neurosurgery 2023-08, Vol.231, p.107837-107837, Article 107837
• Main Authors: Morioka, Jun, Nakahara, Ichiro, Matsumoto, Shoji, Hasebe, Akiko, Tanabe, Jun, Suyama, Kenichiro, Watanabe, Sadayoshi, Suyama, Yoshio, Kuwahara, Kiyonori
• Format: Article
• Language: English
• Subjects: Aneurysm; Aneurysms; Angiography; Antiplatelet therapy; Arteries; Blood clots; Catheters; Contrast agents; Embolization; Endovascular coiling; Endovascular procedures; Interventional radiology; Intracranial aneurysm; Ischemia; Neck; Neurology; Outcome; Patients; Statistical analysis; Stents; Transplants & implants; Veins & arteries; Woven EndoBridge device
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2023.107837

The Woven EndoBridge (WEB) was developed to treat wide-neck bifurcation intracranial aneurysms. Occasionally, persistent contrast-filling has been observed in the WEB after treatment. The purpose of our study was to investigate its incidence, predictive factors, and clinical impact. All patients treated with the WEB between January 2021 and September 2021 at our institute were reviewed. Age, gender, antiplatelet therapy, and angioarchitecture were compared between the persistent-filling group and the no-filling group at the three-month follow-up angiography. We included 20 patients with 20 unruptured aneurysms. Ten of the 20 intracranial aneurysms (50 %) showed contrast-filling in the WEB after three months. Two of the 10 had contrast not only inside, but around the device. Statistically significant differences were observed between the persistent-filling group and the no-filling group in neck size (median: 4.5 mm vs. 3.8 mm), deviation of the aneurysm axis from the inlet flow line where the orifice of the bifurcated arteries overlaps (mean: 15.1° vs. 33.0°), and postoperative dual antiplatelet therapy (DAPT) for at least a month (90 % vs. 20 %). One case had additional coil embolization six months after the WEB implantation. Including this case, one year after the treatment or the re-treatment, the filling in the device had disappeared in nine of 10 cases. No bleeding was observed during the mean follow-up period of 24 months. Persistent contrast-filling was associated with postoperative DAPT for at least a month, a wide neck, and less deviation of the aneurysm axis from the inlet flow line. If the contrast-filling is only within the WEB and not between the aneurysmal wall and the WEB, we are not concerned. To further assess the clinical impact of this phenomenon, long-term follow-up will be needed. •Persistent contrast-filling are observed in the Woven EndoBridge after treatment in10 of 20 cases.•This phenomenon is associated with dual antiplatelet therapy, a wide neck, and less deviation of the aneurysm axis from the inlet flow line.•Contrast-filling only within the Woven EndoBridge appears to have a benign course.