Abstract
A 64-year-old woman was referred to our hospital with an incidental aneurysm of the right internal carotid artery (ICA) bifurcation. A Woven EndoBridge (WEB, MicroVention) device was used as an intrasaccular flow diverter for the treatment of this aneurysm. After the detached WEB later dislodged into the middle cerebral artery (MCA), an Alligator retrieval device (Medtronic) was used for the foreign body extraction. While cases of detachable coils dislodging into and subsequently necessitating removal from intracranial arteries have been sufficiently reported, the same is not true for the WEB. Intra-aneurysmal flow diverters offer an endovascular treatment option for broad-based intracranial aneurysms without having to place a neck-bridging device (e.g., self-expandable stent, remodeling balloon) in the parent artery. Experience with using the WEB as the only established intra-aneurysmal flow diverter is rapidly growing with promising angiographic and clinical results having been achieved over the past few years. Coil migration is a well-known complication in the endovascular treatment of intracranial aneurysms with standard coiling and occurs in up to 6% of cases. Several endovascular rescue strategies address this issue. Here, we describe a case of a secondary displaced WEB device during the treatment of an ICA aneurysm followed by successful withdrawal of the said WEB from the MCA with an Alligator (Medtronic). Removing a dislodged WEB is the main topic of this chapter.
This case report was previously published in the Springer journal Clinical Neuroradiology under open access: König I, Weber A, Weber W, Fischer S. Dislocation of a WEB device into the middle cerebral artery: removal with the Alligator Retrieval Device. Clin Neuroradiol. 2018 May 11. https://doi.org/10.1007/s00062-018-0685-1. [Epub ahead of print]
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König, I., Weber, A., Weber, W., Fischer, S. (2019). Internal Carotid Artery Bifurcation Aneurysm: WEB Device Dislodging into the Middle Cerebral Artery Followed by Removal with an Alligator Retrieval Device and Subsequent Coiling of the Aneurysm. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_70-1
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DOI: https://doi.org/10.1007/978-3-319-70267-4_70-1
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