Snare salvage technique for deformed WEB device after deployment

Abstract

The Woven EndoBridge (WEB) device is a new endovascular technology that allows safe and effective treatment of wide-neck bifurcation aneurysms without the need for dual antiplatelet therapy.1–4 The case is presented of a patient in their 50 s with a history of systemic lupus erythematosus and receiving warfarin for recurrent deep venous thrombosis and an unruptured right middle cerebral artery bifurcation aneurysm. The aneurysm was treated with a WEB SL aneurysm embolization device (MicroVention, Tustin, California, USA). After the final deployment, a technical error (inadvertent forward movement of the pusher) led to the deformation of the device along its longitudinal axis, leaving the aneurysm partially untreated. An Amplatz Goose Neck Microsnare was used to capture the proximal detachment marker and used gentle traction to restore the original shape of the device (video 1).5–7 A follow-up angiogram revealed a restoration of the device’s shape with a similar result during the 4- month follow-up angiogram.Video 1