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10-years’ of experience with the WEB device at Bicêtre: what have we learned?
The day started with Dr Jonathan Cortese’s presentation of the evolution in clinical practice over the last ten years using the Woven EndoBridge device. Aneurysm Size, oversizing the WEB and ruptured aneurysms were all on the table. This led to a nice debate between the faculty.
Treating distal recurrent aneurysm
Live case transmission from, Kasr Al Ainy in Cairo, Egypt and then back to France in a day of sharing experience… and community!
Live – from Cairo
For the first day of LINNC Paris 2022 we began with an interesting case of a recanalized pericallosal aneurysm with stent and coil using the jailing technique. The expert panel debated the use of flow diverting stents in this indication. Then they did a “2-for-1”; treating 2 incidental aneurysms of the ICA using one flow diverter. Should they also coil the aneurysm sac? This question remains the debate with flow diverters. The potential complications of covered side branches were also discussed.
Live – from Bicêtre
Meanwhile back in Paris, the morning saw the two first live cases of the day from Bicêtre hospital, Paris with the team under the direction of Prof. Jacques Moret. The first case was the management of an unusual MCA aneurysm with the plan being to treat using a WEB device assisted by balloon remodeling. This gave the panel and audience the opportunity to discuss the need to use a balloon to tilt the WEB in certain situations. The second case also performed by Prof. Moret, involved treatment of a complex MCA aneurysm with a distal flow diverter through radial access. Perfect sizing with a simulation software helped to deliver the flow diverter without covering deep arteries.
Hemorrhagic cases… caution problems ahead!
The morning session moved to case presentations from Faculty members: hemorrhagic cases and their problems, how were they managed? The afternoon session continued with cases from Canada and France.
Paris – Toronto (part 1)
First, the team of Bicêtre led by Prof. Moret performed a very nice Y-stenting of a recurrent aneurysm using laser-cut stents on a wide neck recurrent termination carotid aneurysm. Then, we saw the Toronto team with Dr Vitor Pereira treating a challenging ACOM using an endosaccular device deployed by robotics. Once more Vitor Pereira demonstrated the interest of robotics in INR procedure.
Paris – Toronto (part 2)
Already we arrived at the two last case of the day. First in Paris, Prof. Jacques Moret and his team planned to embolize a dysplastic side wall right A1 aneurysm with a flow diverter. However, imaging under general anesthesia led to the discovery of a lenticulo-striate artery coming from the sac which contraindicated the treatment choice.
Instead, Prof. Spelle presented a “live” recorded case showing a particular case of small dysplastic aneurysms on an MCA bifurcation treated with a flow diverter. In a second case from Toronto, Dr Vitor Pereira and his team performed a flow diverter stenting of the ICA on a large incidental aneurysm. This challenging aneurysm led to an interesting discussion from the expert panel on flow diverters: indications and techniques.
Ceremony Awards to LINNC Partners
To conclude this wonderful 1st day at the Louvre in Paris, we witnessed the Ceremony Awards to LINNC Partners.
We’ll be following for you tomorrow!
Sincerely,
Jonathan Cortese, Jildaz Caroff and Sophie Gallas
This LINNC Paris daily report is supported by
