Embolization of complex cerebral aneurysm at the middle cerebral artery bifurcation using WovenEndoBridge combined with stent (two case reports)

In recent years, the WovenEndoBridge (WEB), as a representative of emerging intratumoral flow disturbance devices, has been increasingly used in clinical practice. However, there are few reports on how to utilize it correctly when the release position is unsatisfactory or the parent artery is affected during WEB embolization of cerebral aneurysms. We report the treatment process of two female patients who underwent intracranial aneurysm flow diversion therapy for saccular aneurysms at the bifurcation of the middle cerebral artery and benefited from the procedure. The aneurysm embolization was satisfactory during the operation, but the embolization system partially interfered with the parent artery. In order to protect the parent artery and prevent embolism of the Middle Cerebral Artery (MCA) branch, an Atlas stent was introduced to assist in embolization. The angiography was repeated: the parent artery was unobstructed. This article describes in detail the preoperative evaluation of the patient's condition, the surgical plan, and the postoperative treatment. The results of this case confirm the feasibility of stent-assisted WEB embolization of complex aneurysms at the bifurcation of the middle cerebral artery.