How a decade of aneurysms embolization with the Woven EndoBridge has changed our understanding and practices?

Sabuzi, Federico; Cortese, Jonathan; Ros, Valerio Da; Mihalea, Cristian; Chalumeau, Vanessa; Moret, Jacques; Caroff, Jildaz; Spelle, Laurent

doi:10.1016/j.neurad.2023.02.006

Cited by 5 publications

(2 citation statements)

References 18 publications

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Section: New Devicesmentioning

confidence: 99%

“…The WEB device is feasible in the treatment of MCA aneurysms (Figure 7). In particular, the current WEB-17 system is shifting its usage toward small, ruptured, and atypical aneurysms and even sidewall aneurysms (65,71,72). In Adeeb et al 's study of 206 MCA aneurysms treated by the WEB device, the adequate occlusion rate was 84.7, and 90.7% of patients had good clinical outcomes at the last follow-up (73).…”

Section: Woven Endobridge Devicementioning

confidence: 99%

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Endovascular treatment of middle cerebral artery aneurysms: current status and future prospects

Zhou,

Lan,

2023

Front. Neurol.

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Middle cerebral artery (MCA) aneurysms are complex and widely distributed throughout the course of the MCA. Various types of aneurysms can occur in the MCA. Ruptured as well as unruptured MCA aneurysms may require treatment to avoid bleeding or rebleeding. Currently, clipping is regarded as the first-line choice for the treatment of MCA aneurysms. However, endovascular treatment (EVT) is emerging as an alternative treatment in selected cases. EVT techniques vary. Therefore, it is necessary to review EVT for MCA aneurysms. In this review, the following issues were discussed: MCA anatomy and anomalies, classifications of MCA aneurysms, the natural history of MCA aneurysms, EVT status and principle, deployments of traditional coiling techniques and flow diverters (FDs), and deployments and prospects of intrasaccular flow disruptors and stent-like devices. According to the review and our experience, traditional coiling EVT is still the preferred therapy for most MCA aneurysms. FD deployment can be used in selective MCA aneurysms. Parent artery occlusion (PAO) can be used to treat distal MCA aneurysms. In addition, new devices can be used to treat MCA aneurysms, such as intrasaccular flow disruptors and stent-like devices. In general, EVT is gaining popularity as an alternative treatment option; however, there is still a lack of evidence regarding EVT, and longer-term data are not currently available for most EVT devices.

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Section: New Devicesmentioning

confidence: 99%

Section: Woven Endobridge Devicementioning

confidence: 99%

Endovascular treatment of middle cerebral artery aneurysms: current status and future prospects

Zhou,

Lan,

2023

Front. Neurol.

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The Bicêtre occlusion scale is well suited to assess the efficacy of the Contour embolization device

Caroff,

Cortese,

D'Argento

et al. 2024

Journal of Neuroradiology

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Lessons learned from 12 years using the Woven Endobridge for the treatment of cerebral aneurysms in a multi-center series

Goertz,

Liebig,

Siebert

et al. 2024

Sci Rep

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Intrasaccular flow disruption with the Woven Endobridge (WEB) has become a well-established endovascular technique for the treatment of intracranial aneurysms. This study presents our 12-year experience with the WEB and evaluates its evolving indications, procedures, and outcomes. A consecutive series of 324 aneurysms treated with WEB between 2011 and 2023 at three neurovascular centers was retrospectively analyzed and the study group was divided into four treatment periods. Uni- and multivariate analyses were performed to evaluate factors associated with technical success, thromboembolic complications, and angiographic outcome. The mean aneurysm size was 7.0 ± 3.6 mm and decreased during the study period, while the proportion of atypical sites for WEB implantation increased. WEB implantation was technically successful in 96.0%, and the ratio of WEB width to dome width increased during the study period, indicating oversizing. The neurological complication rate was 4.9% (1.5% major, 3.4% minor) and the mid-term complete occlusion rate was 60.6% (81.9% adequate occlusion), with no statistical differences in either outcome measure between the study periods. In multivariate analyses, the use of WEB 17 was associated with increased technical success (HR: 7.4, 95%CI: 2.4-23.6, p<0.01), whereas ruptured aneurysm status (HR: 2.5, 95%CI: 1.0-6.0, p=0.04) and the use of additional stents (HR: 4.8, 95%CI: 1.6-14.4, p<0.01) predicted thromboembolic complications. Appropriate oversizing of the WEB favored mid-term complete occlusion (HR: 10.5, 95%CI: 1.3-83.3, p=0.03). The results suggest an expansion of the indications for WEB implantation and highlight the importance of oversizing for treatment efficacy.

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How a decade of aneurysms embolization with the Woven EndoBridge has changed our understanding and practices?

Cited by 5 publications

References 18 publications

Endovascular treatment of middle cerebral artery aneurysms: current status and future prospects

Endovascular treatment of middle cerebral artery aneurysms: current status and future prospects

The Bicêtre occlusion scale is well suited to assess the efficacy of the Contour embolization device

Lessons learned from 12 years using the Woven Endobridge for the treatment of cerebral aneurysms in a multi-center series

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