Double Duty: Groundbreaking Device Seals and Diverts Blood From Brain Aneurysms

SAP Partner | <b>Allegheny Health Network</b>

Recently, the U.S. Food and Drug Administration approved a new device for challenging aneurysms — the Woven EndoBridge®, or WEB.

Talking on the phone with her husband, all of a sudden, Gwen Prokovich couldn’t speak. The words were stuck in her head. She couldn’t translate them from her brain to her voice.

“I lost my speech for about two minutes, so it was definitely frightening,” said Gwen, 53, and a first grade teacher in the Riverside Beaver County School District.

The minutes felt like hours to Gwen, but her speech eventually returned. Wanting to know the cause, she made an appointment with her primary care physician. For years, Gwen had suffered with migraines, so doctors suspected they caused her temporary speech loss.

But after Gwen met with AHN specialists, her scans painted a different picture.

She had an aneurysm on the right front side of her brain, a middle cerebral artery bifurcation aneurysm. If the bulging artery bursts, Gwen could have a disabling stroke or even die.

“No one can predict a stroke, so prevention is always better,” said Dr. Russell Cerejo, AHN interventional neurologist, who met with Gwen and explained her treatment options.

The standard for minimally invasive brain aneurysm treatment is coil placement. But many patients need multiple coils to fill the aneurysm and sometimes additional devices are needed to support the coils. And the more devices used to treat an aneurysm, the higher the risk for complications.

“This aneurysm had an irregular shape, which made it a higher risk for rupture,” Dr. Cerejo said. “And Gwen preferred to have something done and didn’t want to take the watchful waiting approach.”

Flow diversion is another endovascular option. Instead of placing a coil inside the aneurysm sac, a stent is placed in the parent blood vessel to divert blood flow away from the aneurysm. But in Dr. Cerejo’s experience, some patients’ anatomy don’t match the device seamlessly, making it ineffective.

Other complex brain aneurysms, like Gwen’s, can be treated safely with traditional open surgery if they’re in a shallow enough location. But recently, the U.S. Food and Drug Administration (FDA) approved a new device for challenging aneurysms — the Woven EndoBridge® (WEB).

Shaped like a tiny marshmallow surrounded by woven wires, the WEB device is inserted into a patient’s groin or wrist through a catheter. Threaded into the aneurysm sac, the WEB conforms to the shape of the aneurysm, stopping blood flow and creating a scaffold for long-lasting treatment.

Unlike traditional coil devices, only one WEB device is necessary to treat an aneurysm. In fact, in a study called the WEB-IT pivotal trial,1 the WEB device demonstrated 84.6% adequate sealing. It also proved safe for aneurysms that are difficult to treat with standard coils and adjunct devices. eurologist, who met with Gwen and explained her treatment options.

In the last few years, more than 10,000 WEB devices have been used worldwide to treat aneurysms.

And although it had just recently been approved in the U.S., Gwen didn’t hesitate to choose the WEB.

“For me, watching and waiting was not an option because every time I had a headache and any little twinge, I would worry it was rupturing,” Gwen said. “And the clip and coil had risks, so I said if we’re doing this new device, let’s get it going.”

Recovered, Relieved, and Ready to Teach

Gwen had the one-hour procedure in March and returned home the next day. She said the only pain she dealt with was bruising in her groin where the catheter was inserted.

“I didn’t even have a headache. It really worked out perfectly.”

Dr. Cerejo explained how the device has made a complex procedure much simpler. “We deploy the device into the aneurysm, detach it, pull the catheters out, the patient wakes up from anesthesia, spends a night in the hospital, and can leave as soon as the next day.”

“What makes the WEB device so unique and promising for many patients is that it is a single implant that serves a dual role — it seals the aneurysm and diverts blood flow away from it, all without an open cranial procedure.”

Six months after the procedure, Gwen is preparing for the start of the school year. Her follow-up angiogram confirmed the device was still doing its job, and she’s feeling confident about her health.

“I’m anxious to be back with the kids. I feel like I was extremely well cared for, and now it’s time to return to the classroom and get started.”

For more information, call 412-359-8850.

REFERENCE
The WEB-IT Clinical Study (WEB-IT). Updated May 5, 2021. Accessed January 18, 2022. clinicaltrials.gov/ct2/show/NCT02191618

The WEB™ Aneurysm Embolization System is manufactured by MicroVention Inc. and device images are used with permission. WEB™ Aneurysm Embolization System is a trademark of MicroVention Inc. and is used with permission.