BackgroundThe Woven EndoBridge (WEB) device (MicroVention, Tustin, CA, USA) has an excellent safety profile. While major complications such as device malposition and migration are rare, they can have serious consequences if not addressed promptly. Our case series describes the safety and efficacy of Amplatz goose neck microsnare device (Medtronic in Irvine, CA, USA) in endovascular retrieval of a detached WEB device.MethodsWe retrospectively reviewed six consecutive patients who underwent endovascular WEB retrieval using Amplatz microsnare device between March 2012 and December 2022.ResultsAll six WEB devices were successfully retrieved either directly from the aneurysm sac due to device malpositioning or from a distal branch following device migration. None of the patients experienced intra-operative aneurysm perforation, arterial dissection, or vasospasm attributable to the process of WEB extraction. Five out of six patients (83.3%) had a good functional outcome (mRS 0-1) upon discharge from the hospital and at 24 months.ConclusionOur experience suggests that detached WEB devices can be safely retrieved using an Amplatz microsnare. Apart from addressing device migration, direct removal of an undersized or malpositioned WEB from the aneurysm sac appears to be a safe option that can be considered when all other rescue techniques have been exhausted.

中文翻译：

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微圈套回收作为分离式编织 EndoBridge 装置的救援技术：说明性系列

背景Woven EndoBridge (WEB) 装置（MicroVention，塔斯廷，加利福尼亚州，美国）具有出色的安全性。虽然装置错位和移位等重大并发症很少见，但如果不及时解决，可能会造成严重后果。我们的病例系列描述了 Amplatz 鹅颈微型圈套装置（美国加利福尼亚州欧文市的美敦力公司）在血管内回收分离的 WEB 装置时的安全性和有效性。方法我们回顾性地回顾了 2012 年 3 月期间使用 Amplatz 微型圈套装置进行血管内 WEB 回收的连续 6 名患者和 2022 年 12 月。结果所有六个 WEB 设备均因设备错位而直接从动脉瘤囊中成功取回，或在设备迁移后从远端分支中成功取回。没有患者在 WEB 拔除过程中出现术中动脉瘤穿孔、动脉夹层或血管痉挛。六名患者中的五名 (83.3%) 在出院后和 24 个月时具有良好的功能结果 (mRS 0-1)。结论我们的经验表明，使用 Amplatz 微型圈套器可以安全地取回脱离的 WEB 设备。除了解决装置迁移问题外，直接从动脉瘤囊中去除尺寸过小或错位的网似乎是一种安全的选择，当所有其他救援技术都已用尽时可以考虑。