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ArticleSurgical neurology international2025

Dual Woven EndoBridge deployment and neuroendoscopic hematoma evacuation for a ruptured multilobulated middle cerebral artery aneurysm: A case report.

Shayakhmet Makhanbetkhan, Ichiro Nakahara, Kenichi Haraguchi, Akiko Hasebe, Jun Tanabe, Abzal Zhumabekov, Mynzhylky Berdikhojayev, Fuminari Komatsu, Yashuhiro Yamada, Riki Tanaka and 5 more

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Article in Surgical neurology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Shayakhmet MakhanbetkhanDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Ichiro NakaharaDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Kenichi HaraguchiDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Akiko HasebeDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Jun TanabeDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Abzal ZhumabekovDepartment of Neurosurgery, National Hospital of the Medical Center of Presidential Administration of the Republic of Kazakhstan, Almaty, Kazakhstan.
Mynzhylky BerdikhojayevDepartment of Neurosurgery, National Hospital of the Medical Center of Presidential Administration of the Republic of Kazakhstan, Almaty, Kazakhstan.
Fuminari KomatsuDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Yashuhiro YamadaDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Riki TanakaDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Kento SasakiDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Koutarou KiharaDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Tomoka KatayamaDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Mai OkuboDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Yoko KatoDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Ruptured wide-necked or multi-lobulated intracranial aneurysms pose a challenge in the acute phase of subarachnoid hemorrhage (SAH), in which antiplatelet therapy is generally contraindicated. The Woven EndoBridge (WEB) device enables intrasaccular occlusion without requiring antiplatelet agents. However, the treatment of multilobulated aneurysms in this setting remains technically demanding. Case Description: An octogenarian patient presented with a poor-grade SAH due to a ruptured multilobulated aneurysm of the right middle cerebral artery (MCA) accompanied by intracerebral and subdural hematomas. Emergency endovascular treatment was performed using dual-horizontal WEB devices, each deployed in a separate lobule. Antiplatelet therapy was not administered. Subsequently, a neuroendoscopic hematoma evacuation was performed. Postoperative imaging confirmed complete exclusion of the aneurysm and resolution of the hematoma. The patient showed neurological improvement and was transferred for rehabilitation with acceptable clinical outcomes. Conclusion: This case illustrates the feasibility of combining dual WEB deployment with subsequent neuroendoscopic hematoma evacuation during the acute phase of SAH. This strategy may be a viable treatment option for ruptured multilobulated MCA aneurysms in older adults when conventional approaches are unsuitable.

Indexed as

Dual Woven EndoBridge deploymentMultilobulated aneurysmNeuroendoscopic surgeryRuptured cerebral aneurysmWoven EndoBridge

Identifiers

PMID41036056
PMCPMC12482791

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