J Moret's research while affiliated with Université Paris-Saclay and other places

Publications (305)

Article
Background The CLinical Assessment of WEB device in Ruptured aneurYSms (CLARYS) study has shown that the endovascular treatment of ruptured bifurcation aneurysms with the Woven EndoBridge (WEB) is safe and effective and provides protection against rebleeding at 1 month and 1 year. The 12-month angiographic follow-up is an important endpoint of the...
Article
Background Evaluating a new endovascular treatment for intracranial aneurysms must not only demonstrate short-term safety and efficacy, but also evaluate longer-term outcomes (eg, delayed complications, anatomical results, retreatment). The current analysis reports the 5-year clinical and anatomical results of Woven EndoBridge (WEB) treatment in tw...
Article
Background Woven EndoBridge (WEB) devices are becoming a reliable option for the treatment of wide-neck bifurcation aneurysms, but clear predictive factors are still missing to understand the one in five aneurysm remnant rate. Objective To evaluate occlusion outcomes after WEB treatment to identify potential determinants of aneurysm occlusion. Me...
Article
Purpose: Pediatric intracranial aneurysms (PIA) are rarer and more complex when compared to adult aneurysms. In general, the clinical presentation of PIA is due to a mass effect, but the presenting symptoms can be also related to ischemia, subarachnoid hemorrhage (SAH) or in a combination of different symptoms. This paper aims to report a single-ce...
Article
Five trials published in 2015 showed the benefit of endovascular thrombectomy (ET) in patients with stroke and large vessel occlusion, extending the treatment window has become an obsession of all physicians. In 2018, the DAWN and DEFUSE-3 trials showed that, with careful selection of patients, the procedure could be carried out up to 24 hours afte...
Article
Full-text available
Background The primary goal of the CLARYS study is to assess the protection against rebleeding when treating ruptured bifurcation aneurysms with the Woven EndoBridge (WEB) device. Methods The CLARYS study is a prospective, multicenter study conducted in 13 European centers. Patients with ruptured bifurcation aneurysms were consecutively included b...
Article
Background and purpose: Woven EndoBridge (WEB) devices are increasingly used to treat intracranial aneurysms. A1 asymmetry contributes to anterior communicating artery aneurysm formation and to treatment instability after coiling. We sought to evaluate whether A1 asymmetry had an impact on angiographic outcome in anterior communicating artery aneu...
Article
Background Woven EndoBridge (WEB) device treatment of wide-neck bifurcation aneurysms has proved to be safe and effective, but the use of these devices in sidewall aneurysms has been reported only in a small number of case series. Objective To report our results in a cohort of consecutive patients in whom a WEB device was used as first-line treatm...
Preprint
Full-text available
BACKGROUND AND PURPOSE: The Woven Endobridge has proved to be a safe and effective treatment, especially for wide-neck intracranial aneurysms. The recent fifth-generation Woven Endobridge came with smaller devices. The purpose of this study was to assess the safety and efficiency of Woven Endobridge treatment of small and very small aneurysms.
Article
Background and purpose: The Woven Endobridge has proved to be a safe and effective treatment, especially for wide-neck intracranial aneurysms. The recent fifth-generation Woven Endobridge came with smaller devices. The purpose of this study was to assess the safety and efficiency of Woven Endobridge treatment of small and very small aneurysms. Ma...
Article
Background The Woven EndoBridge (WEB) shape modification (WShM) during follow-up may be a potential cause of poor angiographic outcomes. WShM predisposing factors have not yet been determined. Our systematic use of rotational cone beam computed tomography (VasoCT) imaging during follow-up allowed us to perform the first quantitative analysis of the...
Article
Endovascular treatment is a highly effective therapy for acute ischemic stroke due to large vessel occlusion and has recently revolutionized stroke care. Oftentimes, ischemic core extent on baseline imaging is used to determine endovascular treatment-eligibility. There are, however, 2 fundamental issues with the core concept: First, computed tomogr...
Conference Paper
Purpose WEB device shape modification (WShM) is a potential cause of poor angiographic outcome during follow-up, despite an initial complete aneurysmal occlusion. The prevalence, the factors affecting WShM and the ways to prevent this phenomenon are only partially established. Materials and Methods Patients treated in Bicêtre hospital with a WEB d...
Article
Full-text available
Background WEB treatment is an endovascular approach for wide-neck bifurcation aneurysms that has demonstrated high safety and good efficacy in mid-term follow-up. While evaluating safety in the long term is important to determine if delayed adverse events occur affecting late morbidity and mortality, the most important point to evaluate is the lon...
Article
This case report describes a combined neurosurgical and endovascular approach for the treatment of a conus medullaris arteriovenous malformation resulting in considerable improvement in the patient’s neurological condition (modified Rankin Scale score 2).
Article
Objectif La modification de forme du dispositif WEB est potentiellement à l’origine d’une mauvaise occlusion anévrismale lors du suivi malgré un résultat initial satisfaisant (Fig. 1). La fréquence, les causes et les moyens de prévention de ce phénomène sont jusqu’à ce jour méconnus. Méthodes À l’aide d’acquisitions angiographiques rotationnelles...
Article
This case report describes a combined neurosurgical and endovascular approach for the treatment of a conus medullaris arteriovenous malformation resulting in considerable improvement in the patient’s neurological condition (modified Rankin Scale score 2).
Article
Full-text available
Background: Woven EndoBridge (WEB; Sequent Medical) treatment is an innovative endovascular approach for treatment of wide-neck bifurcation aneurysms. Initial studies have shown high safety with good efficacy at short term confirmed by trials conducted in United States (WEB-Intrasaccular Therapy) and in Europe (WEB Clinical Assessment of Intrasacc...
Article
Background and Purpose— Flow diverters are used for endovascular therapy of intracranial aneurysms. We did a nationwide prospective study to investigate the safety and effectiveness of flow diversion at 12 months. Methods— DIVERSION was a national prospective cohort study including all flow diverters placement between October 2012 and February 201...
Article
Background and purpose The PHASES score was formulated to predict the 5-year risk of rupture for intracranial aneurysms. We retrospectively analyzed all patients treated in our institution for aneurysmal SAH and applied the PHASES score to estimate the probable predicted risk of bleeding in this group of patients. Methods Between February 2015 and...
Article
Background Aneurysms of the anterior communicating artery (ACoA) are difficult to treat with coiling or clipping because of the anatomical variation in this region. Flow diversion represents a feasible treatment, but no consensus exists as to which stent deployment technique is more suitable. Methods All patients with ACoA aneurysms treated with f...
Article
Introduction Le déploiement du dispositif WEB reste difficile dans les anévrismes de forme ou d’orientation complexes. Le but de cette étude était de montrer que l’embolisation d’anévrysmes à bifurcation à col large à l’aide de la technique assistée de remodelage du ballonnet par dispositif WEB est une solution endo-vasculaire réalisable et élégant...
Article
Introduction Le traitement des anévrysmes à bifurcation à collet large reste difficile malgré l’utilisation de nouvelles techniques, telles que le stenting en Y, la technique du « cône gaufré » et les dispositifs intravasculaires de type WEB, ces dernières années. De plus, l’utilisation de stents à déviation de flux dans les anévrismes à bifurcatio...
Article
La prise en charge du stroke commence à être bien codifiée chez l’adulte car de nombreuses études ont validées la technique de thrombectomie et il est maintenant admis que la rapidité de la prise ne charge est un facteur déterminant pour le pronostic du patient. Le stroke chez l’enfant, surtout dans la petite enfance peut souffrir d’un important re...
Article
Introduction Le traitement des anévrismes à bifurcation à collet large reste difficile malgré l’introduction de nouvelles techniques (stent en Y ou stent à dérivation de flux). Le dispositif Woven Endobridge (WEB) est une solution innovante pour ce type d’anévrisme cérébral. Un nouveau site Web 17 est maintenant disponible et a été conçu pour offri...
Article
Background: The authors sought to assess the safety and early efficacy of the pCONUS Bifurcation Aneurysm Implants in a meaningful number of patients; we performed a systematic review and meta-analysis for the treatment of 203 intracranial aneurysms. Methods: A literature search was performed by a reference librarian, and after screening nine ca...
Article
Background: Randomized controlled trials for calcium antagonists therapy in patients with acute ischemic stroke have failed to show a benefit as a stand-alone therapy, due largely to the reduction of blood pressure, especially in the absence of early recanalization. Since mechanical thrombectomy (MT) has led to high successful recanalization rates,...
Article
Background Neo-intimal hyperplasia (NIH) is frequently observed after flow-diverter stent (FDS) implantation. Although mostly asymptomatic, this vascular response can sometimes lead to delayed ischemic strokes. This study intended to evaluate the factors potentially influencing the rates of NIH following FDS treatment. Material and Methods All ane...
Article
Background: Woven EndoBridge (WEB) deployment remains challenging in aneurysms with a complex shape or orientation. Objective: To show that embolization of wide-neck bifurcation aneurysms using the WEB device balloon remodeling-assisted technique is a feasible and elegant endovascular solution compared with other techniques, such as balloon remo...
Article
Objectives: To establish dose reference levels (RLs) for stroke interventions while carefully analysing the impact of clinical and technical parameters on patient exposure. Methods: The study retrospectively analysed data from 377 stroke patients prospectively collected between 15 October 2015 and 30 March 2017 at a single, level-3 stroke centre...
Conference Paper
Introduction The intrasaccular flow diversion device WEB is a system used in the treatment of wide necked bifurcation aneurysm. The large number of clinical studies conducted have included mainly unruptured aneurysms. The CLARYS study has been set up to evaluate the efficacy and the safety of the WEB system used to treat bifurcation ruptured aneury...
Article
Background: The endovascular treatment of wide-neck bifurcation aneurysms can be challenging and often requires the use of adjunctive techniques and devices. Methods: We 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 t...
Article
Full-text available
Intracranial aneurysms (IAs) are acquired cerebrovascular abnormalities characterized by localized dilation and wall thinning in intracranial arteries, possibly leading to subarachnoid hemorrhage and severe outcome in case of rupture. Here, we identified one rare nonsense variant (c.1378A>T) in the last exon of ANGPTL6 (Angiopoietin-Like 6)-which e...
Article
Full-text available
Background Flow disruption with the WEB is an innovative endovascular approach for treatment of wide-neck bifurcation aneurysms. Initial studies have shown a low complication rate with good efficacy. Purpose To report clinical and anatomical results of the WEB treatment in the cumulative population of three Good Clinical Practice (GCP) studies: WE...
Article
Background: Recent reports have revealed a worsening of aneurysm occlusion between WEB treatment baseline and angiographic follow-up due to "compression" of the device. Objective: We utilized computational fluid dynamics (CFD) in order to determine whether the underlying mechanism of this worsening is flow related. Methods: We included data fr...
Article
Full-text available
Background and purpose: The treatment of wide-neck, large basilar apex aneurysms is challenging with either an endovascular or a surgical approach. The aim of the present study was to report our experience treating basilar apex aneurysms with flow-diverter stents and to evaluate their efficacy and safety profile in this specific anatomic condition...
Article
Background and purpose: Hemodynamics is thought to be an important factor for aneurysm progression and rupture. Our aim was to evaluate whether flow fields reconstructed from dynamic angiography data can be used to realistically represent the main flow structures in intracranial aneurysms. Materials and methods: DSA-based flow reconstructions, o...
Article
Background Direct punctures of intracranial tumors have rarely been described in the literature. Objective To assess the feasibility, safety, efficacy, and advantages of using 3D DSA-guided direct puncture rather than the traditional transarterial route to preoperatively devascularize intracranial lesions in particular clinical situations, paying...
Article
Background and purpose: Our aim was to assess the performance of flow-diverter stents. The pre- and end-of-treatment angiographies are commonly compared. However, the arterial flow rate may change between acquisitions; therefore, a better understanding of its influence on the local intra-aneurysmal hemodynamics before and after flow-diverter stent...
Article
Full-text available
Introduction The Woven EndoBridge (WEB) system is an innovative device under evaluation for its capacity to treat wide-neck bifurcation intracranial aneurysms. The purpose of this study is to evaluate the use of the different occlusion scales available in clinical practice. Methods Seven WEB-experienced neurointerventionalists were provided with 30...
Article
Background Flow-diverter stent (FDS) placement for treatment of intracranial aneurysms can cause flow changes in the covered branches. Objective To assess the impact of the treatment of carotid siphon aneurysms with FDS on the posterior communicating artery (PComA) flow. Materials and methods Between February 2011 and January 2015, 125 carotid si...
Article
Full-text available
Purpose During minimally invasive embolization of brain aneurysms the aneurysm sac is filled with metal coils. The post-coiling cone-beam CT image quality is impaired by artifacts originating from the radiopaque metal mass. The artifact streaks run through the brain parenchyma, which hampers their inspection for hemorrhages and other events. Metal...
Article
Full-text available
Background and purpose: Flow disruption with the WEB device is a new technique for the endovascular treatment of wide-neck bifurcation aneurysms. To obtain precise data regarding the safety and efficacy of this treatment with high-quality methodology, the prospective French Observatory study was conducted. Analysis of these data is presented, incl...
Article
Background and purpose: The flow-diverter stent has been proved a feasible, safe, and efficient technique, particularly for the treatment of large and broad-neck carotid siphon aneurysms. Wide-neck bifurcation aneurysms remain, in some cases, a challenge for neurointerventionalists. We report the outcomes of the treatment of saccular middle cerebr...
Article
Full-text available
OBJECT WEB is an innovative intrasaccular treatment for intracranial aneurysms. Preliminary series have shown good safety and efficacy. The WEB Clinical Assessment of Intrasaccular Aneurysm Therapy (WEBCAST) trial is a prospective European trial evaluating the safety and efficacy of WEB in wide-neck bifurcation aneurysms. METHODS Patients with wid...
Article
Full-text available
The safety and efficiency of the dual-layer Woven EndoBridge (WEB) device has already been published. However, this international multicenter study sought to evaluate the safety of single-layer devices, which are the newest generation of the WEB intrasaccular flow-disrupter family. They have been designed to offer smaller-sized devices with a lower...
Article
We read with interest the article by Fiorella et al 1 on interobserver variability in the assessment of aneurysm occlusion with the WEB aneurysm embolisation system recently published in the journal. In this study the authors evaluated the interobserver variability of the previously published Web Occlusion Scale (WOS).2 They showed substantial over...
Article
Full-text available
Object: The concept of the flow-diverter stent (FDS) is to induce aneurysmal thrombosis while preserving the patency of the parent vessel and any covered branches. In some circumstances, it is impossible to avoid dangerously covering small branches, such as the anterior choroidal artery (AChA), with the stent. In this paper, the authors describe t...
Article
Full-text available
Safety analyses in the French Observatory have shown that treatment of intracranial aneurysms by using flow disruption with the Woven EndoBridge Device (WEB) is safe, with low morbidity and no mortality. The objective of this study was to analyze treatment feasibility, complications, and safety results in patients treated with the Woven EndoBridge...
Article
Full-text available
Background: Despite several ongoing studies about new biotechnologies applied to intracranial aneurysms, particularly its genesis, its haemodynamic and its endovascular management; there are few studies with clinical validation until now. Objective: To systematically review studies about biotechnologies used for the treatment of intracranial aneury...
Article
Background and purpose: The safety and efficacy of WEB flow disruption have been analyzed in small, retrospective series. The object of this study was to evaluate the safety and efficacy of WEB flow disruption in a large, multicenter, prospectively collected population. Materials and methods: Data from all patients treated with the WEB-DL device...
Article
Background and purpose WEBCAST is a European study dedicated to the evaluation of the feasibility, safety, and efficacy of endovascular treatment with WEB of intracranial aneurysms. Materials and methods The study was conducted in 10 European centers. Inclusion criteria were aneurysms located at internal carotid artery bifurcation, middle cerebral...
Article
Introduction: Endovascular treatment of ruptured wide-neck bifurcation aneurysms presents a challenge. While still under evaluation, the Woven Endobridge (WEB) aneurysm embolization system has so far shown promising results in the treatment of complex bifurcation aneurysms. We aimed to evaluate the feasibility and short-term follow-up of endovascu...
Article
Endovascular treatment of intracranial aneurysms can be technically difficult when the neck is wide. The Solitaire AB stent, the only fully retrieved stent, assists in the coiling of wide-neck intracranial aneurysms. To evaluate the mid-term angiographic follow-up of wide-necked aneurysms treated with the Solitaire AB stent. SOLARE is a consecutive...
Article
Full-text available
The WEB aneurysm embolization system is still under evaluation but seems to be a promising technique to treat wide-neck bifurcation aneurysms. However, this device is barely visible using conventional DSA; thus, high-resolution contrast-enhanced flat panel detector CT (VasoCT) may be useful before detachment to assess the sizing and positioning of...
Article
Introduction: WEB is a new endosaccular device for treatment of wide neck bifurcation cerebral aneurysms(WNBA). we present a single center experience of 17 cases. Purpose: The 17 cases with WNBA were treated in acute or cold situation. Results: Patients ages range from 43 to 71. 4 cases were treated in the acute phase (<24h), 13 were incidental. Th...
Article
Purpose: Standard coiling is now the first line approach for the treatment of intracranial aneurysms. However, this technique has some limitations, including treatment of wide-neck and large and giant aneurysms and recanalizations. Therefore, new techniques and devices are needed. The objective of intra-saccular flow disruption is the modification...
Article
Cerebral blood volume (CBV) measurement by flat panel detector CT (FPCT) in the angiography suite seems to be a promising tool for patient management during endovascular therapies. A steady state of contrast agent distribution is mandatory during acquisition for accurate FPCT CBV assessment. To the best of our knowledge, this was the first time tha...