C101 DWI/SWI positive after treatment of unruptured anterior communicating artery aneurysm with a Woven EndoBridge device: a case report

<h3>Introduction</h3> Microstrokes during embolization for intracranial aneurysms (IAs) can lead to permanent disability or death. The Woven EndoBridge (WEB) device is widely used for IA treatment, with Diffusion Weighted Imaging (DWI) detecting microembolism and Susceptibility Weighted Imaging (SWI) identifying cerebral microbleeds. However, no reports document postoperative DWI microembolism or SWI microbleeds related to WEB devices in IA treatment. This report presents a case of an unruptured anterior communicating artery (ACA) aneurysm treated with the WEB device, showing positive DWI and SWI findings. <h3>Case Description</h3> A 45-year-old female presented with an unruptured ACA aneurysm (6.11 mm4.43 mm, neck 3.91 mm). Preoperative CTA and DSA confirmed the aneurysm. A WEB device (SL 53 mm) was successfully implanted. Postoperative imaging showed correct device placement and normal flow in the parent artery. On day 2, the patient exhibited right lower extremity weakness, with DWI and SWI revealing microembolisms and microbleeds in the left hemisphere. She was treated with dual antiplatelet therapy (aspirin and ticagrelor) and rehabilitation. By day 5, her condition improved, and follow-up scans at 6 months showed resolution of the microembolisms and microbleeds. <h3>Conclusions</h3> This case demonstrates the utility of DWI and SWI in detecting postoperative microembolisms and microbleeds following WEB treatment for IA. These imaging modalities are crucial for identifying complications, and further studies are needed to optimize antiplatelet therapy in WEB device treatments. <h3>Conflict of Interest</h3> No