Purpose Treatment of wide-necked intracranial aneurysms using the Woven Endobridge (WEB) device has become
broadly accepted. Feared complications with the potential of increased poor clinical outcome include dislocations and
migration of the device. This study was carried out to determine the effectiveness of a variety of different strategies to
rescue migrated WEB devices.
Methods In a porcine model, WEB devices of different sizes (SL [single layer] 3.5 × 2mm and SL 4.0 × 3mm, SL 8 × 5mm
and SLS 8mm [single layer spherical]) were placed into both the subclavian and axillary arteries. A total of 32 rescue
maneuvers (8 per rescue device) were performed. Small WEBs were rescued using reperfusion catheters (RC) (SOFIA Plus
and JET 7), larger WEBs were rescued using dedicated rescue devices (Microsnare and Alligator). Rescue rates, times,
attempts and complications were assessed.
Results Rescue attempts of migrated WEBs were successful in all cases (100%). Rescue time (p= 0.421) and attempts
(p= 0.619) of small WEBs using RCs were comparable without significant differences. Aspiration alone was not successful
for larger WEBs. Rescue of larger WEBs was slightly faster (122.75 ± 41.15 s vs. 137.50 ± 54.46 s) with fewer attempts (1
vs. 1.37) when using the Microsnare compared to the Alligator device. Complications such as entrapment of the WEB in
the RCs, vasospasm, perforation, or dissection were not observed.
Conclusion Rescue of migrated WEB devices is a feasible and effective method and 100% successful rescue rates and
appropriate rescue times can be achieved for small WEBs using RCs and for larger WEBs using dedicated rescue devices
(Microsnare and Alligator)
