Intrasaccular Mesh Plug Treats Brain Aneurysms

The Woven EndoBridge (WEB) device, a product of MicroVention/ Terumo (Aliso Viejo, CA, USA) is an endovascular, intrasaccular solution for the treatment of a wide neck bifurcation aneurysms (WNBAs) with dome diameters of three to 10 mm, a neck size of four mm or greater, or a dome-to-neck ratio between one and two. The self-expanding micro-braid mesh device is made of nitinol wires and a platinum core that bridges the aneurysm neck, disrupting blood flow within the aneurysm, initiating thrombosis, and providing a robust lattice framework for subsequent neoendothelial tissue overgrowth.

During treatment, the physician selects the appropriate device diameter and shape based on size, shape, and location of the intracranial aneurysm; two different shapes are available, a barrel shape (SL) and a sphere shape (SLS). The implant is attached to a delivery system that is navigated to the target aneurysm; proximal and distal radiopaque markers facilitate delivery under fluoroscopic visualization. Subsequently, it is electro-thermally detached with a hand-held, battery-powered, single-use detachment controller inside the aneurysm sac.

“Patients who are not suitable for open aneurysm surgery, or who have recently had a life-threatening rupture and would be at high risk for additional bleeding if treated with conventional endovascular techniques due to the need for blood thinners, now have a viable treatment option,” said Adam Dmytriw, MD, MPH, MSc, founder of the WorldWideWEB Consortium, which unites the experience of 22 institutions across North America, Europe, South America, and Australia.

The WEB device is an endosaccular flow disruption device intended for use in the middle cerebral artery (MCA) bifurcation, the internal carotid artery (ICA) terminus, the anterior communicating artery complex, the basilar artery apex, or any other saccular bifurcation intracranial aneurysms that are not amendable to treatment by open brain surgery or coiling.

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