WEB™ device detachment by MICROVENTION
TutorialThis WEB™ by MicroVention device seals neck and conforms to aneurysm wall, it disrupts flow, protect aneurysm dome and provides scaffold for endothelialization.
It's a single, 3 Dimensional Intrasaccular implant made with Microbraid™ mesh of extremely fine DFT Nitinol-platinum wires. Suitable for unrupted and ruptured aneurysms.
Prior to detachment:
1. Ensure the WEB device and it's access system is in a neutral position
2. Ensure VIA microcatheter is 2-3mm proximal to the proximal marker of the WEB2. The gold connectors on the WEB device pusher wire are free of contrast and blood. Wipe down with water and dry before connecting.
3. The RHV is firmly locked down
Detachment:
1. Connect WDC under fluoro and ensure that it is inserted all the way to ensure proper connection with the gold connectors
2. Check for flashing green light and intermittent beeping tone
3. Push the detachment button. The light will become a solid green and the beep will be continuous.
Verify Detachment:
1. If you didn’t see movement of the WEB device marker during detachment, push the WEB device pusher very slowly to look for any movement of the WEB device
2. If the WEB device is detached, bring the pusher wire back into VIA microcatheter carefully
Troubleshooting steps for suspected WEB non-detachment:
1. Completely remove the WDC and wipe down the proximal end of the pusher and dry. Reintroduce the WDC and ensure that the WEB pusher wire is completely seated. Try detaching the device again and make sure to completely push down on the WDC button.
2. It’s possible there is a sticky detachment (friction between implant and detachment system). This can be resolved with gentle mechanical manipulation. (see section below)
3. If steps 1 & 2 do not work, try detaching the device with a new WDC.
4. If the steps above do not work, carefully remove the WEB device
Troubleshooting steps for sticky detachment :
1. Carefully bring the VIA microcatheter over the detachment zone to the base of the WEB device to brace against the WEB device. In some instances, this manipulation is sufficient to completely detach the WEB device.
2. Bring the pusher wire very slowly into the VIA microcatheter3. Carefully retract the VIA microcatheter to ensure that the proximal marker of the WEB device does not get caught in the tip of the VIA microcatheter.
3. Carefully retract the VIA microcatheter to ensure that the proximal marker of the WEB device does not get caught in the tip of the VIA microcatheter.
