CT angiography for one-year follow-up of intracranial aneurysms treated with the WEB device: Utility in evaluating aneurysm occlusion and WEB compression at one year

• Published in: American journal of neuroradiology : AJNR Vol. 45; no. 6; pp. 343 - 348
• Main Authors: Raoult, Hélène, Eugène, François, Le Bras, Anthony, Mineur, Géraldine, Carsin-Nicol, Béatrice, Ferré, Jean-Christophe, Gauvrit, Jean-Yves
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.10.2018; American Society of Neuroradiology
• Subjects: Adult; Computed Tomography Angiography; Digital subtraction angiography; Embolization, Therapeutic - methods; Female; Follow-Up Studies; Human health and pathology; Humans; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - therapy; Life Sciences; Male; Middle Aged; Observer Variation; Prospective Studies; Radiology; Reproducibility of Results; Time-of-flight contrast-enhanced magnetic resonance angiography; Treatment Outcome; Woven EndoBridge; Computed tomography angiography; Digital subtraction angiography; Time-of-flight contrast-enhanced magnetic resonance angiography; Woven EndoBridge
• ISSN: 0150-9861; 0195-6108; 1936-959X
• DOI: 10.1016/j.neurad.2018.02.010

The WEB is an innovative flow disruption device for cerebral aneurysm embolization with rapidly expanding indications. Our purpose was to evaluate the diagnostic performance of computed tomography angiography (CTA) at 1-year follow-up of aneurysms treated with the WEB. Between April 2014 and May 2016, the study prospectively included patients treated with the WEB at our institution, and followed up within 24hours by CTA and at 1year by CTA, time-of-flight magnetic resonance angiography (TOF MRA) and digital subtraction angiography (DSA). The diagnostic quality of imaging data was assessed based on the confidence index, artifacts, and WEB shape depiction. The imaging diagnostic performance was assessed using 3 criteria at 1year: aneurysm occlusion status and worsening, and WEB shape compression. Interobserver and intermodality agreement was determined by calculating κ values. The study ultimately included 16 patients (9 women, mean age 53±7.6years). CTA quality confidence was scored as 2/2, artifacts 0.4/2 and WEB shape depiction 1.9/2, superior to TOF MRA for the latter two criteria. Aneurysm occlusion was adequate in 93.7% of patients, with CTA showing excellent interobserver reproducibility and agreement with DSA on a 4-grade scale (κ=1.00), while TOF MRA yielded good reproducibility (κ=0.76) and agreement with DSA (κ=0.69). CTA also identified aneurysm occlusion worsening (43.7%) and WEB compression (81.2%) in excellent agreement with DSA (κ=0.85 and 1.00). CTA is a reproducible and reliable technique for the follow-up of aneurysms treated with the WEB device.