Thomas Liebig
I have been focusing on interventional neuroradiology for about 15 years now and have conducted and supervised research on aneurysm treatment, especially flow diversion, with great interest. The technology described in this article is a combination of intrasaccular occlusion and flow diversion or disruption. The focus on ruptured aneurysms was a logical step because this treatment has created the most controversial discussion regarding whether it is safe and stable enough to replace coils or intravessel devices.
Intrasaccular flow disruption is especially interesting in ruptured cases. Broad-based aneurysms can be treated without the need for an additional stent, thus eliminating the need for long-term antiaggregation. Remaining inflow can be seen much better than with coils obscuring the aneurysm lumen, and CT and MRI can be used for follow-up imaging.
The number of such cases has increased over time, with growing confidence. The continuous improvement of the device, and particularly the improved radiopacity that has been introduced recently, has facilitated the procedural aspects. Our findings and other groups’ larger series have proven that the WEB (Sequent Medical, Aliso Viejo, California) is both safe and efficacious in both elective and ruptured cases.
Now, we will actually go back one step and try to visualize and measure both flow and pressure in and behind the WEB in aneurysm models.
The results of this study have been partially presented at our German Society of Neuroradiology meeting.