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Comparative assessment of woven endobridge embolization and standard coil occlusion for the treatment of ruptured basilar tip aneurysms

  • Interventional Neuroradiology
  • Published:
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Abstract

Purpose

Endovascular coil occlusion represents the standard treatment for basilar tip aneurysms. Recently, this role has been rivalled by intrasaccular flow disruptors across numerous centres. We retrospectively compared WEB embolization and coiling for the treatment of ruptured basilar tip aneurysms.

Methods

Patients treated with WEB or coiling at four neurovascular centres were reviewed. Procedure-related complications, clinical outcome, and angiographic results were retrospectively compared.

Results

The study included 23 patients treated with the WEB (aneurysm size: 6.6 ± 1.9 mm) and 56 by coiling (aneurysm size: 6.7 ± 2.5 mm). Stent-assistance was more often necessary with coiling than with WEB embolization (32% vs. 4%, p = 0.009). A modified Rankin scale score ≤ 2 at discharge had 21 (37.5%) patients in the coiling group and 12 (52.2%) in the WEB group (p = 0.235). Immediate complete and adequate occlusion rates were 52% for the WEB and 87% for coiling. At short-term follow-up, these rates were 87% for the WEB and 72% for coiling, respectively. There was no delayed aneurysm re-bleeding during follow-up.

Conclusion

Both coiling and WEB seem to prevent rebleeding in ruptured BTA aneurysms. WEB embolization required less frequently stent-support than coiling, potentially advantageous for SAH patients to avoid anti-platelet therapy in the light of concomitant procedures like ventricular drainage.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. Thomas Liebig and Christoph Kabbasch contributed equally as last authors.

Authors and Affiliations

  1. Department of Radiology and Neuroradiology, University Hospital of Cologne, Cologne, Germany

    Erkan Celik, Lukas Goertz, Marc Schlamann & Christoph Kabbasch

  2. Department of Neuroradiology, Ludwig’s Maximilian University Munich, Munich, Germany

    Yigit Ozpeynirci & Thomas Liebig

  3. Department of Neuroradiology, University Hospital Bonn, Bonn, Germany

    Franziska Dorn & Nils Lehnen

  4. Department of Neuroradiology, University Hospital of Berlin (Charité), Berlin, Germany

    Eberhard Siebert

Authors
  1. Erkan Celik
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  2. Lukas Goertz
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Corresponding author

Correspondence to Erkan Celik.

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Competing interests

CK serves as consultant for Acandis GmbH (Pforzheim, Germany) and as proctor for MicroVention Inc./Sequent Medical (Aliso Viejo, CA, USA). TL serves as proctor for MicroVention Inc./Sequent Medical (Aliso Viejo, CA, USA), CERUS Endovascular (Fremont, CA, USA), Phenox, Stryker, and Medtronic. The other authors declare no competing interests.

Ethics approval

The study protocol was approved by the local ethics committee of the University Hospital of Cologne. The need for informed consent was waived by the local ethics committee of the University Hospital of Cologne. The study was conducted in accordance with the STROBE guidelines in compliance with the national legislation and the Code of Ethical Principles for Medical Research Involving Human Subjects of the World Medical Association (Declaration of Helsinki).

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Celik, E., Goertz, L., Ozpeynirci, Y. et al. Comparative assessment of woven endobridge embolization and standard coil occlusion for the treatment of ruptured basilar tip aneurysms. Neuroradiology 65, 765–773 (2023). https://doi.org/10.1007/s00234-022-03096-4

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