Thromboembolic delayed event after a WEB device implantation managed by mechanical thrombectomy and stenting

Publication date: Available online 10 November 2018

Source: Journal of Neuroradiology

Author(s): Mourad Cheddad El Aouni, Jean-Christophe Gentric, Julien Ognard

Abstract

The Woven EndoBridge (WEB) device is intended to treat wide-neck bifurcation aneurysms. the morbimortality reported in the literature is low. Described postoperative thromboembolic complications of WEB are fairly limited in terms of chronology and management, as low rates of thromboembolic complications at more than one week of treatment are reported. A 60-year-old patient was treated for an unruptured wide-necked middle cerebral artery (MCA) bifurcation aneurysm with a WEB device. Despite preventive dual anti-platelets therapy, eight days after the implantation she presented an acute ischemic stroke with an in situ thrombotic complication. After performing a mechanical thrombectomy using a stent retriever, an open-cell laser-cut nitinol stent was placed. This led to a good clinical outcome. This case illustrates management of local thrombotic complications in patients given intra-saccular treatments, and the potential use of a stent.

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