Treatment of ruptured intracranial aneurysms with the Woven EndoBridge device: a systematic review

The Woven EndoBridge (WEB) device is a barrel-shaped nitinol mesh deployed within the aneurysmal sac. The absence of metallic mesh in the aneurysm’s parent vessel lumen obviates the need for potent antiplatelet therapy, making this device appealing for acutely ruptured aneurysms not amenable to clipping or coiling. To assess the literature regarding WEB treatment of these aneurysms, we performed a comprehensive systematic search of PubMed, MEDLINE, and EMBASE databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Keywords were combined with Boolean operators to increase search sensitivity and specificity (‘woven endobridge device’ AND ‘ruptured’). Nine studies comprising 377 acutely ruptured aneurysms were included. Overall, 82.7% were wide-necked, 85.9% were located in the anterior circulation, and 26.9% of patients presented with poor subarachnoid hemorrhage grade. Intraprocedure and postprocedure complications occurred in 8.4% (95% CI 3.6% to 13.3%) and 1% (95% CI 0% to 2%), respectively. The post-treatment rebleeding rate was 0%. Rates of adequate occlusion (complete occlusion to neck remnant) and retreatment at last follow-up were 84.8% (95% CI 73% to 96.6%) and 4.5% (95% CI 2.2% to 6.8%), respectively. The favorable outcome rate (modified Rankin Scale score 0–2) was 62.2% (95% CI 53% to 71.4%); mortality was 13.6% (95% CI 9.7% to 17.6%). WEB treatment of acutely ruptured aneurysms results in high adequate occlusion rates, low perioperative complication rates, no rebleeding, and low recurrence requiring retreatment. This device is promising for acutely ruptured aneurysms not amenable to clipping or coiling, considering the lower need for antiplatelet regimens during the procedure or follow-up.

Researches Regarding the Compression of the Films Polymers in Composite System

This paper presents experimental research results obtained from testing the compression of polymer matrix composites. The four types are analyzed by thin layers of polymer composite material of various thicknesses were subjected to the test of mechanical compression. The analyzed samples were obtained by reinforcing the siloxane rubber with FeSi powder and stretching the mixture on the metallic mesh (PM), as well as stretching the simple siloxane rubber, without reinforcing agent on the metallic mesh. The mathematical modeling of the experimental results obtained on the LFM 30kN compression tester, Walter & Sai AG was performed using the Excel program. Establishment of material was based on regression analysis performed later. The modulus of elasticity of the samples was determined according to the deformation range 0.1 ÷ 0.3%, corresponding to the maximum correlation coefficient resulting from the regression of the experimental data. Following the compression analyzes it was found that in the case of simple siloxane rubber (S) without filling, the average modulus of elasticity decreases from 80 MPa to 39 MPa for the siloxane rubber laying on the metallic mesh. For the composite material (siloxane rubber with FeSi powder addition) noted SF, the value of the module is 81, and in the case of the laying composite (siloxane rubber reinforced with silicon iron powder filler on the metallic mesh, noted PMSF), the value of the module decreases to 31 MPa. We conclude that the addition of silicon iron powder leads to an increase in the elasticity of the siloxane rubber, and its reinforcement with the metallic mesh leads to a decrease in the elasticity modulus of the siloxane rubber, as well as of the siloxane rubber reinforced with the iron powder.