Turkish Neurosurgery 2023 , Vol 33 , Num 5
Clipping of a Rebleeding Ruptured Aneurysm After Woven EndoBridge Treatment
Mustafa Caglar SAHIN1,Fatih ONCU2,Burak KARAASLAN1
1Gazi University, School of Medicine, Department of Neurosurgery, Ankara, Turkey
2Gazi University, School of Medicine, Department of Radiology, Ankara, Turkey
DOI : 10.5137/1019-5149.JTN.41381-22.2 AIM: To present the clipping of a ruptured aneurysm in the M1 segment of the right middle cerebral artery after rebleeding, which was treated with Woven EndoBridge (WEB).

CASE REPORT: A 68-year-old male patient with known hypertension, coronary artery disease and benign prostatic hypertrophy was admitted to our clinic after a ruptured aneurysm of 4.5 mm in the right middle cerebral artery M1 segment and subarachnoid hemorrhage were detected in the emergency room imaging after syncope at home. WEB device was placed into the aneurysm in the patient who was planned for endovascular treatment. After 3 days of the procedure, neurologic examination showed regression. In the brain computed tomography imaging, it was observed that there was an intraparenchymal hematoma of 4,5 cm in the right temporoparietal region and the aneurysm, which had been treated with endovascular WEB, was ruptured. The aneurysm was clipped in the patient for whom emergency surgical treatment was planned.

CONCLUSION: As a conclusion, re-bleeding can be seen after aneurysm treatment with the Web device. If it is planned to re-close the aneurysm treated with the web device with a surgical clip, the pressure created by the device against the vessel can be reduced with the additional clip. Keywords : Aneurysm, Rebleeding, Woven EndoBridge, WEB device

Corresponding author : Mustafa Caglar SAHIN, dr.mcaglarsahin@gmail.com