Dr. Wei-Te WANGAustria
Department of Neurosurgery, Medical University of Vienna
| 2016 to present | Endovascular specialist |
| 1996 - 2007 | Medical study at Medical University of Vienna |
| 2011 - 2024 | Neurovascular team |
| 2016 - 2019 | Deputy head of neurosurgical intensive care unit |
| 2008 - 2016 | Neurosurgical residency, department of neurosurgery, Medical University of Vienna |
Endovascular neurosurgery, Neurosurgical intensive care
With the main interest in the cerebrovascular field I started my training in hybrid neurosurgery. Due to the high demand of endovascular treatment, I seized the opportunity and focused myself in this sub-specialty. Now, as a member of the faculty I support the training courses for endovascular therapy promoted by EANS in Europe for neurosurgeon.
Preliminary results of pipeline vantage flow diverter: A retrospective single center study
1108 13:55-14:05
Cerebrovascular/304B
Objective:
To report the preliminary experience and result of Pipeline Vantage flow diverter - the 4th generation of Pipeline Embolization Device (PED).
Methods:
A consecutive monocentric case series of intracranial aneurysms or dissections treated with the newest PED was the subject of this retrospective analysis. All available clinical and imaging data including the morphology of the aneurysms, the specification of the devices as well as follow-up documentations with the key aspect of adverse outcome underwent close review.
Results:
During 68 procedures 60 patients with 76 intracranial aneurysms or dissections on 64 target vessel segments were treated with 71 Pipeline Vantage flow diverters. No intraprocedural hemorrhagic event occurs. Unless poor pre-existing condition, any deterioration above modifies Rankin Score of 1 was registered in the non-hemorrhagic sub-group (56 of 60 patients). In this group the mortality rate was 0% compared to 1 patient (25%) in the hemorrhagic sub-group. Overall, minor neurological deficits account 4 (6,7%) patients and one (1,7%) suffers hemiparesis of the right arm. A rare case of previously unknown contact allergy to both nickel and cobalt was observed.
Conclusion:
These preliminary results reveal a promising impression of the Pipeline Vantage flow diverter. Nevertheless, further evaluation with long-term follow-up is required to increase the safety of the patients.
Coagulation management for flow diverter and stent implantation in the acute SAH setting: A retrospective series.
1108 13:25-13:35
Cerebrovascular/304B
Objective:
With the introduction of stent and in particular flow diverter, the endovascular technique can cover a much wider spectrum of brain aneurysm. For these implants an adequate antiplatelet therapy is required. However, the application of the indispensable drugs under hemorrhagic event may lead to adverse outcome. Over the years our institution has adapted the intraoperative loading of tirofiban and the post-procedural switching to oral therapy. Despite the high hemorrhagic risks this series show beneficial results.
Methods:
This consecutive series between January 2020 and April 2024 includes all 25 procedures receiving the intraoperative loading of tirofiban. With the focus on antiplatelet therapy and the further management of coagulation, all cases including follow-ups and outcome were retrospectively reviewed.
Results:
This cohort comprises the acute bleeding group with 15 patients (60%) and the non-bleeding group with 10 patients (40%). No clinical deterioration nor unfavorable outcome (mRS <2) was observed under the non-bleeding individuals. Whereas 5 patients (33%) of the bleeding group suffered with negative consequences (mRS >2). 3 persons died (20% mortality).
Conclusion:
Acute intraoperative loading of tirofiban demonstrates high effectiveness in preventing stent-thrombosis and procedural-related thrombo-ischemic event. With 20% mortality in the bleeding group the result is acceptable in comparison to the natural history of ruptured brain aneurysms.