First in S. Florida: New ‘WEB’ Device Closes, Heals Brain Aneurysms
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It’s called WEB, short for WovenEndoBridge, and it’s a self-expanding mesh ball made of nickeltitanium that is implanted within aneurysms located in the arteries of thebrain.
For patients with potentially dangerous aneurysms, it isalso a new life-saving device approved just months ago by the U.S. Food andDrug Administration. Interventional neuroradiologist Guilherme Dabus,M.D., with Baptist Health Neuroscience Center, thismonth performed the first minimally invasive surgery in South Florida using theWEB on a woman in her 70s who is recovering well.
When brain aneurysms need repair, experts at Baptist HealthNeuroscience Center and Miami Cardiac& Vascular Institute work together to fix them ina minimally invasive manner, without cutting open the skull. In the recentpast, they’ve done this with the help of another innovated device, the flowdiverter. Before the flow diverter was approved, more commonly used balloons, stentsand platinum coils induce clotting (embolization), and hopefully preventingblood from continuing to grow the bulge- or balloon-like aneurysms.
WEB Benefits for Patients
Now the WEB devices (pictured at left) offers many advantages for the patient, including a shorter recovery time, less or no dependence on blood-thinning drugs and potentially fewer complications during a procedure that runs just an hour or less, says Dr. Dabus. Procedures involving coiling and the flow diverter can be more complicated, can take much longer and require the patient to stay on antiplatelet therapy for the rest of their lives.
The WEB implant (pictured above in an illustration) is designed to stop blood flow entering the aneurysm and help promote clotting (thrombosis). Like in other minimally invasive aneurysm procedures, the device is delivered to the aneurysm by snaking a catheter from a blood vessel in the groin or wrist to the brain. Once there, the WEB detaches from the catheter and is placed into the sac of the intracranial aneurysm. Dr. Dabus was able to deploy and control the mesh device after it is deployed into the aneurysm.
“The WEB basically redirects the blood flow away fromthe aneurysm,” says Dr. Dabus. “At the same time, it closes theaneurysm from the inside. And it potentially also serves as a scaffold fortissue healing at the neck of the aneurysm.”
Aneurysm DiagnosedAfter Stroke Treatment
The female patient at Baptist Hospital who underwent one of the first WEBimplants was actually taken to the ER after suffering an ischemic stroke, themost common type of stroke. During an ischemic stroke, the arteries to yourbrain become narrowed or blocked, causing severely reduced blood flow(ischemia). The woman underwent a “mechanical thrombectomy,” in which doctorsremove blood clots using a device threaded through a blood vessel.
The thrombectomy was successful, but then doctors made asurprise discovery — a wide-neck, unruptured bifurcation aneurysm on the otherside of her brain.
“She had the (stroke) procedure done, and then they diagnosedan aneurysm on the other side of her brain, which was a very wide-neck and irregular,”explains Dr. Dabus. “So, she recovered very well from the stroke. We gaveher about ten days and we treated the aneurysm on the other side.”
The patient may be spared having to rely on blood-thinningmedication from the aneurysm treatment perspective, he added.
“When the patient undergoes the procedure with the flowdiverter or stent and coils, we keep them on dual antiplatelet therapy, for sixmonths or so, and then on aspirin forever,” explains Dr. Dabus. “Withthe WEB, sometimes we give the patient both, but it’s usually for a verylimited amount of time. Most of the time, because everything goes well, thepatient does not need to be on any (blood thinner) in the future.”
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