Post-Detachment Displacement of a Woven EndoBridge (WEB) Device Managed via Microcatheter Manipulation: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Objective: To report a case of post-detachment Woven EndoBridge (WEB) displacement successfully managed through microcatheter manipulation alone, avoiding unplanned stenting, which necessitates long-term dual antiplatelet therapy. Case Presentation: A 42-year-old male presented with an unruptured middle cerebral artery bifurcation aneurysm. Device sizing was planned using high-resolution 3D DSA and volumetric analysis on a Siemens ARTIS icono biplane (ARTIS icono VE20 software; Siemens Healthineers, Erlangen, Germany). A WEB SL 5 × 3 mm device (Terumo Neuro, Tustin, CA, USA) was deployed and detached. However, the subsequent withdrawal of an adjunctive microcatheter from a branch vessel caused vascular recoil, leading the detached WEB to rotate and protrude toward the branch orifice, compromising distal flow. Instead of rescue stenting, we performed a "pushing technique" using a Leonis Mova microcatheter (SB-Kawasumi Laboratories, Kanagawa, Japan). The device was successfully reseated within the aneurysm sac, albeit with a 90° rotation. Final angiography confirmed stable seating and excellent branch patency. The patient was discharged without neurological deficits on single antiplatelet therapy. Conclusion: Post-detachment WEB displacement can occur due to dynamic vascular shifts even with precise volumetric sizing. Microcatheter manipulation is a feasible alternative bailout option that preserves the low-profile advantages of the WEB device and avoids the risks associated with rescue stenting.
Institution: Hyogo Medical University
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $150
OpenAlex ID: W7225233786