Post-Detachment Displacement of a Woven EndoBridge (WEB) Device Managed via Microcatheter Manipulation: A Case Report.
- 1Department of Neurosurgery, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
Abstract
To report a case of post-detachment Woven EndoBridge (WEB) displacement successfully managed through microcatheter manipulation alone, avoiding unplanned stenting, which necessitates long-term dual antiplatelet therapy. A 42-year-old male presented with an unruptured middle cerebral artery bifurcation aneurysm. Device sizing was planned using high-resolution 3D DSA and volumetric analysis on a Siemens ARTIS icono biplane (ARTIS icono VE20 software; Siemens Healthineers, Erlangen, Germany). A WEB SL 5 × 3 mm device (Terumo Neuro, Tustin, CA, USA) was deployed and detached. However, the subsequent withdrawal of an adjunctive microcatheter from a branch vessel caused vascular recoil, leading the detached WEB to rotate and protrude toward the branch orifice, compromising distal flow. Instead of rescue stenting, we performed a "pushing technique" using a Leonis Mova microcatheter (SB-Kawasumi Laboratories, Kanagawa, Japan). The device was successfully reseated within the aneurysm sac, albeit with a 90° rotation. Final angiography confirmed stable seating and excellent branch patency. The patient was discharged without neurological deficits on single antiplatelet therapy. Post-detachment WEB displacement can occur due to dynamic vascular shifts even with precise volumetric sizing. Microcatheter manipulation is a feasible alternative bailout option that preserves the low-profile advantages of the WEB device and avoids the risks associated with rescue stenting.
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BibTeX
@article{seo2026postdetachment,
title = {{Post-Detachment Displacement of a Woven EndoBridge (WEB) Device Managed via Microcatheter Manipulation: A Case Report.}},
author = {Kyoichi Seo and Yoji Kuramoto and Soichiro Abe and Shinichi Yoshimura},
journal = {Journal of neuroendovascular therapy},
year = {2026},
month = nov,
doi = {10.5797/jnet.cr.2026-0107},
url = {https://europepmc.org/article/MED/42997185},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Post-Detachment Displacement of a Woven EndoBridge (WEB) Device Managed via Microcatheter Manipulation: A Case Report.
AU - Kyoichi Seo
AU - Yoji Kuramoto
AU - Soichiro Abe
AU - Shinichi Yoshimura
PY - 2026
DA - 2026/11/05
JO - Journal of neuroendovascular therapy
DO - 10.5797/jnet.cr.2026-0107
UR - https://europepmc.org/article/MED/42997185
AB - To report a case of post-detachment Woven EndoBridge (WEB) displacement successfully managed through microcatheter manipulation alone, avoiding unplanned stenting, which necessitates long-term dual antiplatelet therapy. A 42-year-old male presented with an unruptured middle cerebral artery bifurcation aneurysm. Device sizing was planned using high-resolution 3D DSA and volumetric analysis on a Siemens ARTIS icono biplane (ARTIS icono VE20 software; Siemens Healthineers, Erlangen, Germany). A WEB SL 5 × 3 mm device (Terumo Neuro, Tustin, CA, USA) was deployed and detached. However, the subsequent withdrawal of an adjunctive microcatheter from a branch vessel caused vascular recoil, leading the detached WEB to rotate and protrude toward the branch orifice, compromising distal flow. Instead of rescue stenting, we performed a "pushing technique" using a Leonis Mova microcatheter (SB-Kawasumi Laboratories, Kanagawa, Japan). The device was successfully reseated within the aneurysm sac, albeit with a 90° rotation. Final angiography confirmed stable seating and excellent branch patency. The patient was discharged without neurological deficits on single antiplatelet therapy. Post-detachment WEB displacement can occur due to dynamic vascular shifts even with precise volumetric sizing. Microcatheter manipulation is a feasible alternative bailout option that preserves the low-profile advantages of the WEB device and avoids the risks associated with rescue stenting.
SN - 1882-4072
SN - 2186-2494
ER -