From the Research
The occlusion rates for web devices in treating pericallosal anterior cerebral artery brain aneurysms range from 79-92% at 6-12 months follow-up, as reported in the most recent and highest quality study 1.
Overview of Web Devices
Web devices, which are intrasaccular flow disruptors, have shown promising results for these challenging aneurysms located in the distal anterior cerebral artery.
Factors Affecting Occlusion Rates
Complete occlusion typically occurs gradually over time, with approximately 60% immediate occlusion rates that improve to 80-90% by one year post-procedure. Factors affecting occlusion rates include aneurysm size (smaller aneurysms tend to occlude more completely), neck width (narrow-necked aneurysms respond better), and the absence of incorporated branches.
Mechanism of Action
The web device works by disrupting blood flow within the aneurysm sac, promoting thrombosis while preserving the parent vessel.
Post-Procedure Care
Patients typically require dual antiplatelet therapy (aspirin 81-325mg daily and clopidogrel 75mg daily) for 3-6 months post-procedure, followed by aspirin monotherapy for an additional 3-6 months.
Follow-Up
Regular angiographic follow-up at 6 and 12 months is essential to confirm occlusion status, as some aneurysms may require retreatment if incomplete occlusion persists. Some key points to consider when using web devices for treating pericallosal anterior cerebral artery brain aneurysms include:
- Technical success rate of 96% (95% CI: 0.93 to 1.00) and a technical complication rate was 3% (95% CI: 0.00 to 0.06) 1
- Perioperative rates of ischemic stroke, hemorrhagic stroke, morbidity, and mortality were 3% (95% CI: 0.00 to 0.06), 5% (95% CI: 0.01 to 0.08), 3% (95% CI: 0.00 to 0.06 and 2% (95% CI: 0.00 to 0.05), respectively 1
- The rate of treatment-related, long-term neurological deficit was 4% (95% CI: 0.01 to 0.07) 1
- Complete occlusion rate at last radiological follow-up was 79% (95% CI: 0.68 to 0.91) 1