Angiographic C-arm CT visualization of the Woven EndoBridge cerebral aneurysm embolization device (WEB): first experience in an animal aneurysm model

Clin Neuroradiol. 2014 Mar;24(1):43-9. doi: 10.1007/s00062-013-0224-z. Epub 2013 May 28.


Introduction: Improvements in the imaging capabilities of angiographic C-arm computed tomography (CT) using flat detector angiographic (FD-CT) systems now provide a means for the in vivo visualization of devices used for the treatment of intracranial aneurysms. One such device, the WEB embolization device, is made of a braided mesh of nitinol wires, the size of which are near to the limits of visualization using conventional x-ray fluoroscopy. Our hypothesis was that the imaging of these implants C-arm CT would provide useful information regarding their positioning and deployment.

Methods: In five New Zealand white rabbits elastase induced aneurysms were created and subsequently treated using a WEB. Imaging was performed using digital subtraction angiography (DSA), X-ray imaging and two different Angiographic C-arm CT protocols. The images were evaluated by two neuroradiologists using an evaluation scale.

Results: The mesh of the WEB was barely visible on the DSA or x-ray fluoroscopy images. Volume rendering technique (VRT) reconstruction and multiplanar reconstruction (MPR) of images done using the C-arm CT protocols clearly delineated the shape and structure of the device. Contrast-enhanced MPR and VRT reconstructions allowed assessment of the status of blood flow in the aneurysms. Beam hardening artifacts caused by platinum markers on the WEB were present.

Conclusion: In vivo C-arm CT imaging of the WEB is feasible and allows precise determination of the position and deployment status of the device. On contrast-enhanced images the occlusion status of aneurysms and the positioning of the WEB in relationship to the parent artery can be evaluated. C-arm-CT may serve as a minimal-invasive follow-up imaging modality.

MeSH terms

  • Animals
  • Cerebral Angiography / methods*
  • Equipment Failure Analysis
  • Intracranial Aneurysm / chemically induced
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / therapy*
  • Mechanical Thrombolysis / instrumentation*
  • Mechanical Thrombolysis / methods
  • Pancreatic Elastase
  • Prosthesis Design
  • Rabbits
  • Radiography, Interventional / methods*
  • Surgical Mesh*
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome


  • Pancreatic Elastase