Safety and Efficacy of the Woven EndoBridge Device for Treatment of Ruptured Intracranial Aneurysms: A Systematic Review and Meta-analysis

Essibayi, Muhammed Amir; Lanzino, Giuseppe; Brinjikji, Waleed

doi:10.3174/ajnr.a7174

Cited by 29 publications

(16 citation statements)

References 35 publications

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“…The Woven EndoBridge (WEB) device (Microvention, CA) currently represents the most extensively studied intrasaccular device,1 2 and has proven to be a very safe option to treat wide-necked bifurcation aneurysms 3. Since its introduction, angiographic results have improved year on year, likely due to the sharing of operator experiences in device sizing,4 5 and yet 5–12% of patients still require retreatment 3 6–10…”

Section: Introductionmentioning

confidence: 99%

Management of aneurysmal recurrence after Woven EndoBridge (WEB) treatment

Caroff

Janot

Soize

et al. 2022

J NeuroIntervent Surg

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BackgroundAround 10% of Woven EndoBridge device (WEB)-treated intracranial aneurysms will need retreatment, and it is generally believed to be more challenging than retreatment after an initial coiling. We aim to report retreatment strategies and outcomes after initial WEB embolizations.MethodsDatabases from four treatment centers, containing consecutive aneurysms treated with a WEB between 2013 and 2022, were reviewed. Demographics, aneurysm characteristics, retreatment strategies and outcomes were collected and analyzed.ResultsFrom a 756 WEB database, 57 aneurysms were included. The global retreatment rate was 7.5% (95% CI 5.6% to 9.4%). The retreatment rate was significantly higher in the ruptured compared with the unruptured population (13% vs 3.9%, respectively, P<0.0001). Aneurysms were retreated on average 21.2 months after the initial WEB treatment (range 4.8–70 months). Surgery was performed in 11% and endovascular treatment in 89% of cases, consisting of flow diversion (48%), stent-assisted coiling (30%), coiling (12%), and second WEB placement (10%). Imaging follow-up was available in 88% of all WEB retreatments (50/57) (average 17 months, 49% digital subtraction angiography), demonstrating complete occlusion in 56% and ‘adequate’ occlusion in 88%. Morbidity was 5.3% (95% CI 0% to 12.0%) and mortality 0%. No patient experienced rebleeding during the follow-up period.ConclusionThe retreatment rate after an initial WEB treatment seems to compare favorably with that of coiling. Endovascular treatment of recurrence following WEB implantation is feasible in most situations; it generally requires the use of a stent and leads to a high rate of satisfactory occlusion.

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Section: Introductionmentioning

confidence: 99%

Management of aneurysmal recurrence after Woven EndoBridge (WEB) treatment

Caroff

Janot

Soize

et al. 2022

J NeuroIntervent Surg

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“…This is comparable to the reported literature, as Youssef et al [ 14 ], in a study involving 48 patients with ruptured IAs, reported adequate occlusion in 92.3% at a median follow up of 5.5 months, and Cortez et al [ 15 ], in a study of 91 patients with ruptured IAs, demonstrated 80% adequate occlusion at a mean follow up of 3.4 months. A subsequent meta-analysis by Essibayi et al [ 16 ] pooled 487 patients with 496 ruptured aneurysms treated with WEB, reporting an adequate occlusion rate of 87.3%. The single mortality in our series was unrelated to WEB deployment.…”

Section: Discussionmentioning

confidence: 99%

The Woven EndoBridge Device for the Treatment of Intracranial Aneurysms: Initial Clinical Experience within an Australian Population

Gajera¹,

Maingard²,

Foo³

et al. 2022

Neurointervention

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Purpose: Advances in endovascular technology have expanded the treatment options for intracranial aneurysms. Intrasaccular flow diversion is a relatively new technique that aims to disrupt blood inflow at the neck of the aneurysm, hence promoting intrasaccular thrombosis. The Woven EndoBridge device (WEB; MicroVention, Aliso Viejo, CA, USA) is an US Food and Drug Administration approved intrasaccular flow diverter for wide-necked aneurysms. We report the early interim clinical and radiological outcomes of patients with both ruptured and unruptured intracranial aneurysms (IAs) treated using the WEB device in an Australian population.Materials and Methods: A retrospective analysis was done of patients with ruptured or unruptured IAs who received treatment with WEB across 5 Australian neuroendovascular referral centers between May 2017 and November 2020. Angiographic occlusion was assessed with time-of-flight magnetic resonance angiography. Complications were recorded and clinical outcomes were assessed using the modified Rankin scale at follow-up.Results: In total, 66 aneurysms were treated in 63 patients, with successful deployment of the WEB device in 98.5% (n=65). Eighteen (26.9%) ruptured aneurysms were included. Failure of deployment occurred in a single case. Adjunct coiling and/or stenting was performed in 20.9% (n=14) cases. Sixty-two patients with 65 aneurysms using a WEB device were followed up (mean=9.1 months), and 89.4% of these had complete aneurysm occlusion while 1.5% remained patent. Functional independence was achieved in 93.5% of cases.Conclusion: Early results following the use of WEB devices in Australia demonstrate safety and adequate aneurysm occlusion comparable to international literature.

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Section: Discussionmentioning

confidence: 99%

“…WEB meta-analyses have pointed to a high rate of selection bias in the WEB studies analyzed [ 20 , 21 , 22 ]. In the study period, our Center treated all WNBA patients with WEB, adding quality to this long-term follow-up study [ 21 , 22 ]. Moreover, this study is the only one assessing a long-term follow-up exclusively by DSA, the gold standard technique for cerebral aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Woven EndoBridge in Wide-Neck Bifurcation Aneurysms: Digital Subtraction Angiography at 3-Year Follow-Up

Stanca

Carriero

Negroni

et al. 2022

JCM

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Introduction: The Woven EndoBridge (WEB) device is a self-expanding intrasaccular braided-wire device for the treatment of wide-neck bifurcation aneurysms (WNBAs). Even though this device has an excellent safety profile and a low risk of rebleeding, little is known about its long-term effects. Material and Methods: All patients treated with WEB due to ruptured WNBAs were subjected to follow-up digital subtraction angiography (DSA) at 2 and 3 years after device deployment. The degree of residual neck was assessed through BOSS, Lubicz, and WEBCAST scales. Data on modified Rankin scale (mRS), bleeding events, and ischemic events occurring during this time period were collected as well. Lastly, overall and procedure-related mortality rates were calculated. Results: A total of 21 patients were treated between 1 January 2016, and 31 December 2018. DSA demonstrated a patency grade of 57.1% and 61.1% at 2 and 3 years, respectively. The overall 2-year mortality rate due to causes unrelated to the aneurysm was 14.3%. None of the patients were retreated between the 2- and the 3-year follow-up. No rebleeding or stroke events occurred during the follow-up. Conclusions: WEB-treated ruptured aneurysms showed an excellent degree of stability over time. The overall mortality rate—unrelated to the procedure–observed in our sample was higher than what reported in the literature, a possible bias associated with the COVID-19 pandemic.

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Safety and Efficacy of the Woven EndoBridge Device for Treatment of Ruptured Intracranial Aneurysms: A Systematic Review and Meta-analysis

Abstract: BACKGROUND:The Woven EndoBridge device has been increasingly used to treat wide-neck aneurysms, particularly ruptured ones. PURPOSE: Our aim was to investigate the safety and efficacy of the Woven EndoBridge device in the treatment of ruptured intracranial aneurysms.

Cited by 29 publications

References 35 publications

Management of aneurysmal recurrence after Woven EndoBridge (WEB) treatment

Management of aneurysmal recurrence after Woven EndoBridge (WEB) treatment

The Woven EndoBridge Device for the Treatment of Intracranial Aneurysms: Initial Clinical Experience within an Australian Population

Woven EndoBridge in Wide-Neck Bifurcation Aneurysms: Digital Subtraction Angiography at 3-Year Follow-Up

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