Use of a Woven Endobridge device (WEB) for the treatment of an aneurysmal diverticulum of the transverse sinus causing pulsatile tinnitus.

Pulsatile tinnitus is a symptom with a potentially significant impact on the quality of life of patients.1 In some cases the pulsatile tinnitus is secondary to an arterial, arteriovenous, or a venous condition that can be treated endovascularly.2-5 One of the newly recognized entities that can cause pulsatile tinnitus is the presence of an ipsilateral aneurysmal diverticulum of the transverse sinus. The Woven EndoBridge (WEB) is an intra-aneurysmal flow disruptor for the treatment of broad-based arterial aneurysms with a high safety and effectiveness profile.3 The initial version of the WEB with a dual-layer structure evolved into a single-layer structure in two different versions (WEB SL, a barrel shape, and WEB SLS, a spherical shape).4 The WEB system does not require concomitant antiplatelet therapy, unlike other intraluminal devices such as flow diverters or intracranial stents. We describe a case of pulsatile tinnitus secondary to an aneurysmal diverticulum of the transverse sinus successfully treated with a WEB SL device instead of stent-assisted coiling, therefore alleviating the need for antiplatelets (video 1). The patient had an immediate clinical response with complete and persisting disappearance of her pulsatile tinnitus.neurintsurg;jnis-2023-020981v1/V1F1V1Video 1.