Application of the Woven EndoBridge Device in the Treatment of Multiple Aneurysms of the Distal Posterior Cerebral Artery: A Case Report.

Abzal Zhumabekov, Jun Tanabe, Ichiro Nakahara, Mynzhylky Berdikhojayev, Yoko Kato
Author Information
  1. Abzal Zhumabekov: Department of Neurosurgery, National Hospital of the Medical Center of Presidential Administration of the Republic of Kazakhstan, Almaty, Kazakhstan.
  2. Jun Tanabe: Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Japan.
  3. Ichiro Nakahara: Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Japan.
  4. Mynzhylky Berdikhojayev: Department of Neurosurgery, Medical Center Hospital of the President's Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan.
  5. Yoko Kato: Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Japan.

Abstract

The Woven EndoBridge (WEB) device has emerged as a promising alternative to endovascular coiling. This case report demonstrates the use of stent-assisted WEB deployment for the embolization of multiple wide-neck posterior cerebral artery (PCA) aneurysms. A middle-aged patient was diagnosed with 3 unruptured aneurysms in the P3 and P4 segments of the right PCA, with sizes ranging from 2.5 mm to 6.6 mm. Given the small vessel diameter and distal location of the aneurysms, a combined approach was adopted. Coil embolization was performed for the most distal aneurysm, while stent-assisted WEB deployment was used for the proximal and middle aneurysms. The "flower bud" technique facilitated the safe positioning of the WEB device in challenging anatomical conditions. The procedure was successfully completed without complications, and the patient was discharged on postoperative day 7 with no neurological deficits. Follow-up at 3 months confirmed adequate embolization of all aneurysms, with in-stent stenosis managed conservatively.

Keywords

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