Woven EndoBridge (WEB) device used for vertebral artery sacrifice

In this case study, we presented a challenging neurovascular intervention where a Woven EndoBridge (WEB) intrasaccular device was used to treat a 4.5 mm ruptured vertebral artery fusiform aneurysm by sacrificing the vessel with great precision. The patient had a dissection of the left vertebral artery at the posterior inferior cerebellar artery (PICA) origin. The WEB device was deployed immediately proximal to the origin of the PICA. After WEB deployment, further stasis and occlusion were achieved with coils. This combination of the WEB device and coils allowed for a precise and controlled sacrifice, ensuring continued filling of the PICA from the contralateral vertebral artery. The outcome of the procedure was successful, as the patient experienced complete vessel occlusion with no adverse effects. This case demonstrates a non-standard use of the WEB device in tandem with coils to treat a ruptured fusiform vertebral artery aneurysm.