Rescue snaring of Woven EndoBridge (WEB) with direct retrieval from aneurysm sac.

Abstract

The Woven EndoBridge (WEB) device is an intrasaccular flow disruption device designed for the treatment of wide-necked aneurysms.^{1, 2} Once deployed into the aneurysm it initiates intra-aneurysmal stasis, thrombosis and occlusion, and flow diversion at the interface of the neck of the aneurysm with the parent vessel.³ The device offers the advantage of reduced operating time and reduced radiation exposure to the patient and the operator. We present a case of a patient in their 70s with a subarachnoid haemorrhage secondary to a ruptured aneurysm at the bifurcation of the right middle cerebral artery. Endovascular treatment was initially attempted with a 7 × 2 mm WEB single layer. Its inadvertent displacement following deployment occluded the superior M2 branch. A snare device was used to capture the proximal marker of the WEB and retrieve the device (Video 1).^{4- 5} The aneurysm was subsequently treated during the same session with a balloon and Comaneci-assisted coiling.