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    Endovascular treatment of intracranial aneurysms using the Woven EndoBridge (WEB) device: retrospective analysis of a single center experience
    (Elsevier Science Inc, 2020) Kaya, Hasan E.; Bakdik, Suleyman; Keskin, Fatih; Erdi, Mehmet F.; Koc, Osman
    Introduction: Woven EndoBridge (WEB) is an innovative device for the treatment of intracranial aneurysms especially wide-necked bifurcation aneurysms. Here we present our experience with the WEB device. Material and methods: Patients treated using only the WEB device between September 2014 and November 2018 were included in the study. Follow up imaging studies and medical records of the patients were retrospectively reviewed. Results: Forty-two aneurysm of 42 patients (27 female, 15 male; median age: 56, range: 32-76) were treated using the WEB device. The mean diameter of the aneurysms was 6.6 mm (range: 3-12 mm). The neck diameter was >= 4 mm in 57% of the aneurysms. The locations of the aneurysms were the middle cerebral artery bifurcation in 29 (69%), basilar tip in 5 (12%), anterior communicating artery in 5 (12%), internal carotid artery tip in 2 (5%), and M1 segment of the middle cerebral artery in 1 (2%) of the patients. Five patients had subarachnoid hemorrhage due to aneurysm rupture. The device could be successfully deployed in all of the cases. There were control imaging studies available for 36 patients who were followed up for a median of 7 months (range: 1-33 months). Adequate occlusion was observed in 35 of these 36 patients (97%). There was no treatment related morbidity or mortality. Conclusion: Although long term follow-up data are not available, WEB intrasaccular flow disruptor seems to be effective and safe for intracranial bifurcation aneurysm treatment in the mid-term follow up.
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    Multiple Cerebral Aneurysms and Subacute-Subdural Hematoma Coexistence With Multiple Meningiomas: A Case Report
    (Lippincott Williams & Wilkins, 2013) Keskin, Fatih; Kalkan, Erdal; Erdi, Mehmet F.
    Multiple aneurysms and multiple meningiomas coexistance can be seen rarely. Subarachnoid hemorrhage and subacute subdural hematoma coexistance in the same case is very rare. The female patient, at the age of 52, was hospitalized through emergency service with temporary blackout and severe headache complaints. There were no signs of trauma seen during her physical examination. Neck stiffness was positive. The patient's Glasgow Coma Scale score was 15. Right frontoparietal subacute subdural hematoma and subarachnoid hemorrhage were determined with computerized brain tomography. Contrast enhanced magnetic resonance imaging showed two lesions which were sized 1.5x0.5 cm and 2.5x2.0 cm in the left occipital lobe. Bilateral middle cerebral artery (MCA) bifurcation aneuryms were determined at cerebral angiography. Bilateral MCA bifurcation aneurysm clippage and total excision of both tumoral lesions were done in the same operation with bilateral pterional and left occipital craniotomy. Pathological investigation of the tumoral lesions were reported as meningioma. The postoperative stage was uneventful. The patient's neurological examination was intact without any neurological deficit. Multiple cerebral aneurysms and multiple meningiomas coexistance can be seen rarely in the course of some connective tissue diseases and neurofibromatosis. In this report we present a case of multiple aneurysms and meningiomas without connective tissue disease or neurofibromatosis. The patient was treated succesfully by different surgical approaches in the same session.