Basilar Artery Bifurcation Aneurysm: Ruptured Wide-Necked Basilar Bifurcation Aneurysm Presenting with Atypical Clinical Signs and Symptoms, Treated with a WEB Device After a Failed Attempt at Coil Occlusion

  • Maxim BesterEmail author
  • Jens Fiehler
  • Jan-Hendrik Buhk
Living reference work entry


A 40-year-old male patient was referred to our emergency room with non-specific symptoms such as becoming progressively more agitated and a change in personality. While taking his medical history with his wife, she described a sudden onset of symptoms during sexual intercourse which then worsened. A scheduled CT scan revealed a basal subarachnoid hemorrhage graded at Hunt and Hess II, Fisher IV, due to a ruptured wide-neck basilar bifurcation aneurysm. After an initial unsuccessful treatment attempt using just a coil to occlude the aneurysm, the patient was successfully treated with a WEB device. The treatment of basilar artery bifurcation aneurysms with efferent arteries incorporation using a Woven EndoBridge (WEB) is the main topic of this chapter.


Basilar artery bifurcation Wide-necked bifurcation aneurysm Coil occlusion failed attempt Woven EndoBridge WEB 


  1. Asnafi S, Rouchaud A, Pierot L, Brinjikji W, Murad MH, Kallmes DF. Efficacy and safety of the Woven EndoBridge (WEB) device for the treatment of intracranial aneurysms: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2016;37(12):2287–2292.4. Scholar
  2. Liebig T, Kabbasch C, Strasilla C, Berlis A, Weber W, Pierot L, Patankar T, Barreau X, Dervin J, Kuršumović A, Rath S, Lubicz B, Klisch J. Intrasaccular flow disruption in acutely ruptured aneurysms: a multicenter retrospective review of the use of the WEB. AJNR Am J Neuroradiol. 2015;36(9):1721–7. Scholar
  3. Nawka MT, Sedlacik J, Frölich A, Bester M, Fiehler J, Buhk JH. Multiparametric MRI of intracranial aneurysms treated with the Woven EndoBridge (WEB): a case of Faraday’s cage? J Neurointerv Surg. 2018. pii: neurintsurg-2017-013625.CrossRefGoogle Scholar
  4. Pierot L, Moret J, Turjman F, Herbreteau D, Raoult H, Barreau X, Velasco S, Desal H, Januel AC, Courtheoux P, Gauvrit JY, Cognard C, Molyneux A, Byrne J, Spelle L. WEB treatment of intracranial aneurysms: clinical and anatomic results in the French observatory. AJNR Am J Neuroradiol. 2016;37(4):655–9. Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Klinik und Poliklinik für Neuroradiologische Diagnostik und InterventionUniversitätsklinikum Hamburg-EppendorfHamburgGermany

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