• Cristian Mihalea, Jildaz Caroff, Aymeric Rouchaud, Sorin Pescariu, Jacques Moret, and Laurent Spelle.
• Bicetre Hospital, Paris, France; SCJUT Timisoara, Romania/Sanador Hospital, Bucharest Romania; Interventional Neuroradiology, Le Kremlin-Bicetre, France. Electronic address: cristianmihalea@yahoo.com.
• World Neurosurg. 2018 May 1; 113: 73-77.

BackgroundThe endovascular treatment of wide-neck bifurcation aneurysms can be challenging and often requires the use of adjunctive techniques and devices.MethodsWe report our first experience of using a waffle-cone technique adapted to the Woven Endoluminal Bridge (WEB) device in a large-neck basilar tip aneurysm, suitable in cases where the use of Y stenting or other techniques is limited due to anatomic restrictions.ResultsThe procedure was complete, and angiographic occlusion of the aneurysm was achieved 24 hours post treatment, as confirmed by digital subtraction angiography. No complications occurred.ConclusionsThe case reported here was not suitable for Y stenting or deployment of the WEB device alone, due to the small caliber of both posterior cerebral arteries and their origin at the neck level. The main advantage of this technique is that both devices have a controlled detachment system and are fully independent. To our knowledge, this technique has not been reported previously and this modality of treatment has never been described in the literature.Copyright © 2018 Elsevier Inc. All rights reserved.

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