Case report reveals delayed thromboembolic complication 18 days after Woven EndoBridge placement for brain aneurysm, suggesting potential value of short-term antiplatelet therapy.
Background: The Woven EndoBridge (WEB) is an intrasaccular flow disruptor for the treatment of wide-neck aneurysm. Most thromboembolic complications (TECs) occur during or shortly after the procedure. We report a case of TEC occurring 18 days after WEB deployment. Case Description: A man in his 80s underwent WEB treatment for anterior communicating artery aneurysm and was discharged without complications or postoperative antiplatelet therapy. Eighteen days later, he developed sudden left leg weakness. Magnetic resonance imaging demonstrated an acute infarction in the right anterior cerebral artery (ACA) territory and digital subtraction angiography revealed thrombotic filling defects extending from the WEB device into the right ACA. Aspirin (200 mg) and prasugrel (20 mg) with systemic heparinization were promptly initiated, resulting in complete thrombus resolution. Conclusion: Delayed TEC can occur beyond the immediate periprocedural period after WEB treatment. Short-term postoperative antiplatelet therapy may be beneficial even after apparently uncomplicated WEB implantation.
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Miyama et al. (2026) studied this question.
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