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Bocanegra-Becerra JE, Kersting K, Blega AM, Brown N, Oliveira LDB, Alajarmeh R, Batista S, Wellington J, Acha Sánchez JL, Bertani R. Endovascular treatment of brain aneurysms under conscious sedation: a systematic review of procedural feasibility and safety. Neurosurg Rev 2024; 47:42. [PMID: 38214744 DOI: 10.1007/s10143-023-02272-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/11/2023] [Accepted: 12/31/2023] [Indexed: 01/13/2024]
Abstract
Over the last decades, minimally invasive techniques have revolutionized the endovascular treatment (EVT) of brain aneurysms. In parallel, the development of conscious sedation (CS), a potentially less harmful anesthetic protocol than general anesthesia (GA), has led to the course optimization of surgeries, patient outcomes, and healthcare costs. Nevertheless, the feasibility and safety of EVT of brain aneurysms under CS have yet to be assessed thoroughly. Herein, we systematically reviewed the medical literature about this procedure. In accordance with the PRISMA guidelines, four databases (PubMed, EMBASE, SCOPUS, and Cochrane Library) were queried to identify articles describing the EVT of brain aneurysms under CS. Successful procedural completion, complete aneurysm occlusion outcomes, intraoperative complications, clinical outcomes, and mortality rates assessed the feasibility and safety. Our search strategy yielded 567 records, of which 11 articles were included in the qualitative synthesis. These studies entailed a total of 1142 patients (40.7% females), 1183 intracranial aneurysms (78.4% in the anterior circulation and 60.9% unruptured at presentation), and 1391 endovascular procedures (91.9% performed under CS). EVT modalities under CS included coiling alone (63.2%), flow diversion (17.7%), stent-assisted coiling (10.6%), stenting alone (6.5%), onyx embolization alone (1.7%), onyx + stenting (0.2%), and onyx + coiling (0.2%). CS was achieved by combining two or more anesthetics, such as midazolam, fentanyl, and remifentanil. Selection criteria for CS were heterogenous and included patients' history of pulmonary and cardiovascular diseases, outweighing the benefits of CS versus GA, a Hunt and Hess score of I-II, a median score of 3 in the American Society of Anesthesiology scale, and patient's compliance with elective CS. Procedures were deemed successful or achieving complete aneurysm occlusion in 88.1% and 9.4% of reported cases, respectively. Good clinical outcomes were described in 90.4% of patients with available data at follow-up (mean time: 10.7 months). The procedural complication rate was 16%, and the mortality rate was 2.8%. No complications or mortality were explicitly attributed to CS. On the other hand, procedure abortion and conversion from CS to GA were deemed necessary in 5% and 1% of cases, respectively. The present study highlights the feasibility of performing EVT of brain aneurysms under CS as an alternative anesthetic protocol to GA. However, the limited nature of observational studies, methodological quality, the predominant absence of a comparative GA group, and clinical data during follow-up restrict a conclusive statement about the safety of EVT under CS. Accordingly, further research endeavors are warranted toward a higher level of evidence that can be translated into surgical practice.
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Affiliation(s)
| | - Katharina Kersting
- Charité-Universitätsmedzin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universtitä Zu Berlin, Berlin, Germany
| | - Alin Maximilian Blega
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Nolan Brown
- Department of Neurosurgery, University of California-Irvine, Orange, CA, USA
| | | | - Rnad Alajarmeh
- Department of Pediatrics, Istiklal Hospital, Amman, Jordan
| | - Sávio Batista
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jack Wellington
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Raphael Bertani
- Department of Neurosurgery, University of São Paulo, São Paulo, Brazil
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2
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Dmytriw AA, Dibas M, Ghozy S, Adeeb N, Diestro JDB, Phan K, Cuellar-Saenz HH, Sweid A, Lay SV, Guenego A, Renieri L, Al Balushi A, Saliou G, Möhlenbruch M, Regenhardt RW, Vranic JE, Lylyk I, Foreman PM, Vachhani JA, Župančić V, Hafeez MU, Rutledge C, Waqas M, Tutino VM, Rabinov JD, Ren Y, Schirmer CM, Piano M, Kühn AL, Michelozzi C, Elens S, Starke RM, Hassan A, Salehani A, Sporns P, Jones J, Psychogios M, Spears J, Lubicz B, Panni P, Puri AS, Pero G, Griessenauer CJ, Asadi H, Stapleton CJ, Siddiqui A, Ducruet AF, Albuquerque FC, Du R, Kan P, Kalousek V, Lylyk P, Boddu S, Tjoumakaris S, Knopman J, Aziz-Sultan MA, Limbucci N, Jabbour P, Cognard C, Patel AB. The Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: Ten Years of Lessons Learned and Adjustments in Practice from the WorldWideWEB Consortium. Transl Stroke Res 2023; 14:455-464. [PMID: 36066701 DOI: 10.1007/s12975-022-01072-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/27/2022] [Accepted: 07/25/2022] [Indexed: 10/14/2022]
Abstract
Several studies have shown promising outcomes of the Woven EndoBridge (WEB) device for the treatment of wide-necked intracranial bifurcation aneurysms. This is a multicenter study attempts to explore the changes in trends and treatment outcomes over time for WEB embolization of intracranial aneurysms. The WorldWideWEB consortium is a retrospective multicenter collaboration of data from international centers spanning from January 2011 and June 2021, with no limitations on aneurysm location or rupture status. Both bifurcation and sidewall aneurysms were included. These patients were stratified based on treatment year into five treatment intervals: 2011-2015 (N = 66), 2016-2017 (N = 77), 2018 (N = 66), 2019 (N = 300), and 2020-2021 (N = 173). Patient characteristics and angiographic and clinical outcomes were compared between these time intervals. This study comprised 671 patients (median age 61.4 years; 71.2% female) with 682 intracranial aneurysms. Over time, we observed an increasing tendency to treat patients presenting with ruptured aneurysms and aneurysms with smaller neck, diameter, and dome widths. Furthermore, we observed a trend towards more off-label use of the WEB for sidewall aneurysms and increased adoption of transradial access for WEB deployment. Moreover, the proportion of patients with adequate WEB occlusion immediately and at last follow-up was significantly higher in more recent year cohorts, as well as lower rates of compaction and retreatment. Mortality and complications did not differ over time. This learning curve study suggests improved experience using the WEB for the treatment of intracranial aneurysms and has yielded higher rates of adequate occlusion over time.
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Affiliation(s)
- Adam A Dmytriw
- Neurointerventional Program, Departments of Medical Imaging & Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada.
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA.
| | - Mahmoud Dibas
- Neurointerventional Program, Departments of Medical Imaging & Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada
| | - Sherief Ghozy
- Department of Neuroradiology, Mayo Clinic, Rochester, MN, USA
| | - Nimer Adeeb
- Departement of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, LA, USA
| | - Jose Danilo Bengzon Diestro
- Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Kevin Phan
- Interventional Radiology and Neurointerventional Services, Department of Radiology, Austin Health, Melbourne, Victoria, Australia
| | - Hugo H Cuellar-Saenz
- Departement of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, LA, USA
| | - Ahmad Sweid
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Sovann V Lay
- Service de Neuroradiologie Diagnostique Et Thérapeutique, Centre Hospitalier de Toulouse, Hôpital Purpan, Toulouse, France
| | - Adrien Guenego
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Leonardo Renieri
- Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy
| | - Ali Al Balushi
- Neurosurgery & Interventional Neuroradiology, New York Presbyterian Hospital, Weill Cornell School of Medicine, New York, NY, USA
| | - Guillaume Saliou
- Service de Radiodiagnostic Et Radiologie Interventionnelle, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland
| | - Markus Möhlenbruch
- Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Robert W Regenhardt
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA
| | - Justin E Vranic
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA
| | - Ivan Lylyk
- Equipo de Neurocirugía Endovascular Y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina
| | - Paul M Foreman
- Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA
| | - Jay A Vachhani
- Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA
| | - Vedran Župančić
- Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia
| | - Muhammad U Hafeez
- Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA
| | - Caleb Rutledge
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Muhammad Waqas
- Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA
| | - Vincent M Tutino
- Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA
| | - James D Rabinov
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA
| | - Yifan Ren
- Interventional Radiology and Neurointerventional Services, Department of Radiology, Austin Health, Melbourne, Victoria, Australia
| | - Clemens M Schirmer
- Department of Neurosurgery and Radiology, Geisinger Hospital, Danville, PA, USA
| | - Mariangela Piano
- Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milan, Italy
| | - Anna L Kühn
- Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA, USA
| | | | - Stéphanie Elens
- Service de Neuroradiologie Interventionnelle, Hôpital Universitaire Erasme, Brussels, Belgium
| | - Robert M Starke
- Deparment of Neurosurgery, University of Miami, Miami, FL, USA
| | - Ameer Hassan
- Deparment of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, USA
| | - Arsalaan Salehani
- Deparments of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Peter Sporns
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jesse Jones
- Deparments of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marios Psychogios
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julian Spears
- Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Boris Lubicz
- Service de Neuroradiologie Interventionnelle, Hôpital Universitaire Erasme, Brussels, Belgium
| | - Pietro Panni
- Interventistica Neurovascolare, Ospedale San Raffaele Milano, Milan, Italy
| | - Ajit S Puri
- Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA, USA
| | - Guglielmo Pero
- Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milan, Italy
| | - Christoph J Griessenauer
- Department of Neurosurgery and Radiology, Geisinger Hospital, Danville, PA, USA
- Department of Neurosurgery, Christian Doppler University Hospital, Paracelsus Medical University Salzburg, Salzburg, Austria
- Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria
| | - Hamed Asadi
- Interventional Radiology and Neurointerventional Services, Department of Radiology, Austin Health, Melbourne, Victoria, Australia
| | - Christopher J Stapleton
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA
| | - Adnan Siddiqui
- Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA
| | - Andrew F Ducruet
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA
| | | | - Rose Du
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA
| | - Peter Kan
- Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA
| | - Vladimir Kalousek
- Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia
| | - Pedro Lylyk
- Equipo de Neurocirugía Endovascular Y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina
| | - Srikanth Boddu
- Neurosurgery & Interventional Neuroradiology, New York Presbyterian Hospital, Weill Cornell School of Medicine, New York, NY, USA
| | | | - Jared Knopman
- Neurosurgery & Interventional Neuroradiology, New York Presbyterian Hospital, Weill Cornell School of Medicine, New York, NY, USA
| | - Mohammad A Aziz-Sultan
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA
| | - Nicola Limbucci
- Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy
| | - Pascal Jabbour
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Christophe Cognard
- Service de Neuroradiologie Diagnostique Et Thérapeutique, Centre Hospitalier de Toulouse, Hôpital Purpan, Toulouse, France
| | - Aman B Patel
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA
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Adeeb N, Dibas M, Amireh A, Kandregula S, Cuellar H. Comparison of transradial and transfemoral access for the Woven EndoBridge embolization of intracranial aneurysms: A single-center experience. Interv Neuroradiol 2022; 28:531-537. [PMID: 34549662 PMCID: PMC9511614 DOI: 10.1177/15910199211043736] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/10/2021] [Accepted: 08/16/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Transradial access has been adopted more commonly in the neuroendovascular field. However, the experience of using this access for the Woven EndoBridge embolization of intracranial aneurysms is still in the early stage. OBJECTIVE This study aimed to compare the outcomes between transradial access and transfemoral access for the Woven EndoBridge embolization of intracranial aneurysms. METHODS This is a retrospective analysis of consecutive intracranial aneurysms treated with Woven EndoBridge placement between May 2019 and August 2020 by the senior author at a high-volume center. The aneurysms of all sizes and locations treated with Woven EndoBridge placement with or without adjunctive stent or coiling were included. Patient demographics, aneurysm and treatment characteristics, procedural complications, and angiographic and functional outcomes were compared between two approaches. RESULTS This study included a total of 34 patients with intracranial aneurysms (median age 60 years, female-to-male ratio 2:1). Of these, the radial access was utilized in 20 (58.8%) patients, while the femoral access was used in 14 (41.2%) patients. A Woven EndoBridge device was successfully deployed in all cases, and none of the patients required a crossover to another access. There were no significant differences in baseline characteristics, procedure time and fluoroscopy time, outcomes, and complication rates between both groups. CONCLUSION Our report suggests the possible feasibility and safety of the transradial access for the Woven EndoBridge embolization of intracranial aneurysms. However, the results of this study are suggestive rather than conclusive, and there is still a need for future large prospective studies.
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Affiliation(s)
- Nimer Adeeb
- Department of Neurosurgery, Ochsner LSU Medical Center, Louisiana State University, Shreveport, LA, USA
| | - Mahmoud Dibas
- Department of Neurosurgery, Ochsner LSU Medical Center, Louisiana State University, Shreveport, LA, USA
| | - Abdallah Amireh
- Department of Neurosurgery, Ochsner LSU Medical Center, Louisiana State University, Shreveport, LA, USA
| | - Sandeep Kandregula
- Department of Neurosurgery, Ochsner LSU Medical Center, Louisiana State University, Shreveport, LA, USA
| | - Hugo Cuellar
- Department of Neurosurgery, Ochsner LSU Medical Center, Louisiana State University, Shreveport, LA, USA
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Dibas M, Adeeb N, Diestro JDB, Cuellar HH, Sweid A, Lay SV, Guenego A, Aslan A, Renieri L, Sundararajan SH, Saliou G, Möhlenbruch M, Regenhardt RW, Vranic JE, Lylyk I, Foreman PM, Vachhani JA, Župančić V, Hafeez MU, Rutledge C, Waqas M, Tutino VM, Rabinov JD, Ren Y, Schirmer CM, Piano M, Kühn AL, Michelozzi C, Elens S, Starke RM, Hassan AE, Salehani A, Sporns P, Jones J, Psychogios M, Spears J, Lubicz B, Panni P, Puri AS, Pero G, Griessenauer CJ, Asadi H, Stapleton CJ, Siddiqui A, Ducruet AF, Albuquerque FC, Kan P, Kalousek V, Lylyk P, Boddu S, Knopman J, Aziz-Sultan MA, Limbucci N, Jabbour P, Cognard C, Patel AB, Dmytriw AA. Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score-matched study. J Neurosurg 2022; 137:1064-1071. [PMID: 35120326 DOI: 10.3171/2021.12.jns212293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/16/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Transradial access (TRA) is commonly utilized in neurointerventional procedures. This study compared the technical and clinical outcomes of the use of TRA versus those of transfemoral access (TFA) for intracranial aneurysm embolization with the Woven EndoBridge (WEB) device. METHODS This is a secondary analysis of the Worldwide WEB Consortium, which comprises multicenter data related to adult patients with intracranial aneurysms who were managed with the WEB device. These aneurysms were categorized into two groups: those who were treated with TRA or TFA. Patient and aneurysm characteristics and technical and clinical outcomes were compared between groups. Propensity score matching (PSM) was used to match groups according to the following baseline characteristics: age, sex, subarachnoid hemorrhage, aneurysm location, bifurcation aneurysm, aneurysm with incorporated branch, neck width, aspect ratio, dome width, and elapsed time since the last follow-up imaging evaluation. RESULTS This study included 682 intracranial aneurysms (median [interquartile range] age 61.3 [53.0-68.0] years), of which 561 were treated with TFA and 121 with TRA. PSM resulted in 65 matched pairs. After PSM, both groups had similar characteristics, angiographic and functional outcomes, and rates of retreatment, thromboembolic and hemorrhagic complications, and death. TFA was associated with longer procedure length (median 96.5 minutes vs 72.0 minutes, p = 0.006) and fluoroscopy time (28.2 minutes vs 24.8 minutes, p = 0.037) as compared with TRA. On the other hand, deployment issues were more common in those treated with TRA, but none resulted in permanent complications. CONCLUSIONS TRA has comparable outcomes, with shorter procedure and fluoroscopy time, to TFA for aneurysm embolization with the WEB device.
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Affiliation(s)
- Mahmoud Dibas
- 1Neuroradiology & Neurointervention Service, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Nimer Adeeb
- 2Department of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, LA
| | - Jose Danilo Bengzon Diestro
- 3Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, ON, Canada
| | - Hugo H Cuellar
- 2Department of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, LA
| | - Ahmad Sweid
- 4Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA
| | - Sovann V Lay
- 5Service de Neuroradiologie Diagnostique et Thérapeutique, Centre Hospitalier de Toulouse, Hôpital Purpan, Toulouse, France
| | - Adrien Guenego
- 4Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA
| | - Assala Aslan
- 2Department of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, LA
| | - Leonardo Renieri
- 6Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy
| | - Sri Hari Sundararajan
- 7Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, NY
| | - Guillaume Saliou
- 8Service de radiodiagnostic et radiologie interventionnelle, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland
| | - Markus Möhlenbruch
- 9Sektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Robert W Regenhardt
- 10Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA
| | - Justin E Vranic
- 10Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA
| | - Ivan Lylyk
- 11Equipo de Neurocirugía Endovascular y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina
| | - Paul M Foreman
- 12Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL
| | - Jay A Vachhani
- 12Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL
| | - Vedran Župančić
- 13Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center "Sisters of Mercy," Zagreb, Croatia
| | - Muhammad U Hafeez
- 14Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX
| | - Caleb Rutledge
- 15Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ
| | - Muhammad Waqas
- 16Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY
| | - Vincent M Tutino
- 16Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY
| | - James D Rabinov
- 10Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA
| | - Yifan Ren
- 17Interventional Radiology and Neurointerventional Services, Department of Radiology, Austin Health, Melbourne, Victoria, Australia
| | - Clemens M Schirmer
- 18Department of Neurosurgery and Radiology, Geisinger Hospital, Danville, PA
| | - Mariangela Piano
- 19Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milano, Italy
| | - Anna L Kühn
- 20Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA
| | | | - Stéphanie Elens
- 22Service de Neuroradiologie Interventionnelle, Hôpital Universitaire Erasme, Brussels, Belgium
| | - Robert M Starke
- 23Department of Neurosurgery, University of Miami, Miami, FL
| | - Ameer E Hassan
- 24Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX
| | - Arsalaan Salehani
- 25Department of Neurosurgery, University of Alabama at Birmingham, AL; and
| | - Peter Sporns
- 26Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jesse Jones
- 25Department of Neurosurgery, University of Alabama at Birmingham, AL; and
| | - Marios Psychogios
- 26Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julian Spears
- 3Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, ON, Canada
| | - Boris Lubicz
- 22Service de Neuroradiologie Interventionnelle, Hôpital Universitaire Erasme, Brussels, Belgium
| | - Pietro Panni
- 21Interventistica Neurovascolare, Ospedale San Raffaele, Milano, Italy
| | - Ajit S Puri
- 20Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA
| | - Guglielmo Pero
- 19Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milano, Italy
| | | | - Hamed Asadi
- 17Interventional Radiology and Neurointerventional Services, Department of Radiology, Austin Health, Melbourne, Victoria, Australia
| | | | - Adnan Siddiqui
- 16Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY
| | - Andrew F Ducruet
- 15Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ
| | | | - Peter Kan
- 14Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX
| | - Vladimir Kalousek
- 13Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center "Sisters of Mercy," Zagreb, Croatia
| | - Pedro Lylyk
- 11Equipo de Neurocirugía Endovascular y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina
| | - Srikanth Boddu
- 7Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, NY
| | - Jared Knopman
- 7Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, NY
| | - Mohammad A Aziz-Sultan
- 2Department of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, LA
| | - Nicola Limbucci
- 6Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy
| | - Pascal Jabbour
- 4Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA
| | - Christophe Cognard
- 5Service de Neuroradiologie Diagnostique et Thérapeutique, Centre Hospitalier de Toulouse, Hôpital Purpan, Toulouse, France
| | - Aman B Patel
- 10Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA
| | - Adam A Dmytriw
- 1Neuroradiology & Neurointervention Service, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- 10Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA
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5
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Son C, Tavakoli-Sabour S. Transradial access for embolization of cerebral aneurysms with the woven EndoBridge device: Case series and review of the literature. Interv Neuroradiol 2021; 27:207-211. [PMID: 33175617 PMCID: PMC8050528 DOI: 10.1177/1591019920972216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Transradial access is an increasingly utilized route for neurointerventions with benefits of lower rates of access site complications, earlier patient mobilization and increased patient satisfaction over transfemoral interventions. There is limited data on deployment of the Woven EndoBridge (WEB) via transradial access. We report a case series of consecutive patients undergoing cerebral aneurysm embolization with the WEB device via transradial biaxial access. METHODS A database of neuroendovascular procedures was queried for consecutive aneurysm embolization procedures involving the WEB device and intended via the transradial approach between August 2019 and July 2020. Patient demographics, radiological aneurysm characteristics and procedure details were recorded and statistically evaluated. Google Scholar and Pubmed were searched for previous reports of transradial WEB embolization. RESULTS Ten aneurysms were treated in ten patients. All aneurysms were treated with successful WEB deployment. Nine of the ten aneurysms were successfully treated via transradial biaxial access. One aneurysm required conversion to transfemoral access. There were no clinical complications and no morbidity or mortality. CONCLUSIONS Transradial embolization of cerebral aneurysms with the WEB device is safe and feasible with low rates of access failure or complications.
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Affiliation(s)
- Colin Son
- Neurosurgical Associates of San Antonio, San Antonio, TX, USA
| | - Samon Tavakoli-Sabour
- Department of Neurosurgery, University of Texas Health Science Center, San Antonio, TX, USA
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