Novel treatment effective for sidewall brain aneurysm, study finds


Date:
April 19, 2022
Source:
Radiological Society of North America
Summary:
A novel mesh plug that has been traditionally used to treat brain
aneurysms occurring where the blood vessels branch out was found
to be equally effective in treating aneurysms on the side of the
vessel, according to a new study.



FULL STORY ==========================================================================
A novel mesh plug that has been traditionally used to treat brain
aneurysms occurring where the blood vessels branch out was found to
be equally effective in treating aneurysms on the side of the vessel,
according to a study in the journal Radiology.


========================================================================== Aneurysms result from a weakness in the blood vessel wall that typically
occurs where the vessel branches or bifurcates -- where the vessel
divides or forks into two branches. Untreated, an aneurysm can grow and rupture. A common treatment involving the placement of tiny platinum
coils into the aneurysm has limitations.

"If the aneurysm has a wide neck, the coil might fall into the blood
vessel and lead to clot formation and incomplete aneurysm occlusion," said study lead author Nimer Adeeb, M.D., from the Department of Neurosurgery
and Interventional Neuroradiology at Louisiana State University in
Shreveport, Louisiana. "Many times, you end up putting a stent in the
blood vessel to prevent the coils from falling out and to keep them
compacted within the aneurysm. This can have its own complications and
requires using blood thinners." A braided wire device known as the
Woven EndoBridge (WEB) was developed to overcome those limitations. The
device is placed inside the aneurysm under angiographic guidance, where
it causes a clot to form, closing off the aneurysm and reducing the risk
of bleeding without requiring supporting stents or blood thinners.

"After you put the WEB device through the neck of the aneurysm, it
opens up," Dr. Adeeb said. "Given that it's bigger than the neck of
the aneurysm, it usually stays in place. One quick procedure is usually
enough for successful treatment." The U.S. Food and Drug Administration
(FDA) approved the WEB device for wide- neck intracranial bifurcation aneurysms. Some specialists have used it off- label for the treatment
of sidewall aneurysms, a type of wide-necked aneurysm that occurs at
the side of a blood vessel rather than its bifurcation tip.



========================================================================== Research on the WEB device's use in wide-necked sidewall aneurysms has
been limited to studies with a small number of cases.

For the new study, Dr. Adeeb and colleagues compared the WEB device
in bifurcation and sidewall aneurysms using a large database spanning
more than 10 years from the WorldWideWEB consortium, a group of 23
academic institutions in North America, South America, Australia and
Europe. Dr. Adeeb co-led the effort with Adam A. Dmytriw, M.D., from Massachusetts General Hospital in Boston.

A total of 683 intracranial aneurysms were treated using the WEB device
in 671 patients. Of those, 572 were bifurcation aneurysms, and 111 were sidewall aneurysms. Propensity score matching, a way to increase the
power of a study by accounting for differences in patients, resulted in
91 bifurcation and sidewall aneurysms pairs.

The complication rate was very similar between the two approaches.

"We found out that there is no significant difference using the WEB device
in sidewall aneurysms compared with bifurcation aneurysms," Dr. Adeeb
said. "The results show that the WEB device is safe and effective to
use for sidewall aneurysms." Dr. Adeeb hopes that the study will help
drive a discussion about expanding the indications for the WEB device
to include certain sidewall aneurysms.

As additional institutions continue to join the consortium, Dr. Adeeb and
his colleagues are continuing the research, comparing the WEB device with
other treatments for different types and locations of aneurysms. They
also plan to track changes that happen to device shape and compaction
over time and its relationship to aneurysm occlusion status.

"Our ultimate goal is to provide our patients with the best possible
treatment for their brain aneurysms," he said.


========================================================================== Story Source: Materials provided by
Radiological_Society_of_North_America. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Nimer Adeeb, Mahmoud Dibas, Jose Danilo Bengzon Diestro, Hugo
H. Cuellar-
Saenz, Ahmad Sweid, Sandeep Kandregula, Sovann V. Lay, Adrien
Guenego, Leonardo Renieri, Sri Hari Sundararajan, Guillaume
Saliou, Assala Aslan, Markus Mo"hlenbruch, Justin E. Vranic, Robert
W. Regenhardt, For the WorldWideWEB Consortium. Multicenter Study
for the Treatment of Sidewall versus Bifurcation Intracranial
Aneurysms with Use of Woven EndoBridge (WEB). Radiology, 2022;
DOI: 10.1148/radiol.212006 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/04/220419103201.htm

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