The Woven EndoBridge device for ruptured intracranial aneurysms: international multicenter experience and updated meta-analysis

Harker, Pablo; Regenhardt, Robert W; Alotaibi, Naif M.; Vranic, Justin E; Robertson, Faith C.; Dmytriw, Adam A.; Ku, Jerry C.; Koch, Matthew J.; Stapleton, Christopher J.; Leslie‐Mazwi, Thabele M; Serna, N; Pabón, B; Mejia, J

doi:10.1007/s00234-021-02727-6

Cited by 18 publications

(18 citation statements)

References 31 publications

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“…Basilar apex aneurysms were the most frequently treated by WEB (57.1%), whereas middle cerebral artery bifurcation WBNAs were the least treated (4.8%). Our results are in contrast with previous studies showing that WBNAs of the middle cerebral artery bifurcation are the most frequently treated aneurysms with WEB—i.e., 48% in the Harker et al meta-analysis [ 12 ]. This discrepancy may be due to the multidisciplinary approach adopted in our study, where a team formed by neurosurgeons and interventional neuroradiologists more often select basilar apex WBNA patients for endovascular treatment, while the middle cerebral artery WBNA were selected for neurosurgical clipping.…”

Section: Discussionmentioning

confidence: 99%

“…Fittingly, after placement of the WEB device, there was no new reperfusion of the aneurysms sac after 2- and 3-years. One of the largest meta-analysis of coiling cerebral aneurysm treatment documented a reperfusion rate ranging between 7.2% and 29.6%—mean follow-up ranging from 4.7 to 38 months [ 12 ]. Comparing to the data coiling with the limitations of this study, WEB treatment would appear to have a lower reperfusion rate in this study.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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“…In this multicenter study, 60 patients with 60 ruptured bifurcation aneurysms to be treated with the WEB were included, and the interim results appeared to be promising. Essibayi et al ( 26 ) and Harker et al ( 27 ) have published systematic reviews and meta-analyses about the use of WEB for ruptured aneurysms. Both of them showed promising results but were focused on ruptured aneurysms, and the risk of bias may be high because they are based on single-arm clinical experiences without a control group.…”

Section: Discussionmentioning

confidence: 99%

Treatment of unruptured middle cerebral artery aneurysms: Systematic review in an attempt to perform a network meta-analysis

Arrese

García-García²,

Cepeda³

et al. 2022

Front. Surg.

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ObjectiveOpen surgical clipping has been generally considered the best treatment option for unruptured middle cerebral artery aneurysms (uMCAAs). However, this type of aneurysm is being treated endovascularly with the appearance of new devices. We have carried out a systematic review of randomized and quasi-experimental studies to conduct a network meta-analysis (NMA) to assess the safety and efficacy of the different treatment methods currently used in uMCAAs.MethodsThe literature was searched by using PubMed and Google Scholar databases. Eligibility criteria were randomized or quasi-experimental studies including at least five cases per arm and reporting duration of follow-up and number of lost cases. The end points were: angiographic success, final neurological outcome, and the need for retreatments.ResultsWe could only analyze four quasi-experimental studies with 398 uMCAAs. All of them compared clipping vs. coiling. Clipping showed better results than coiling in all analyzed end points. We could not conduct the proposed NMA because of the absence of randomized or quasi-experimental studies. Instead, a systematic review is further discussed.ConclusionsThere is an urgent need for comparative studies on the treatment of uMCAAs.

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“…In three studies favorable rates of occlusion of 84.8%,16 86.4%,17 and 91%,18 respectively, were reported. Harker et al only reported complete occlusion with 62% at 4 months,19 with good clinical outcome of modified Rankin Scale <2 in 62.2%,16 75%,18 88.7%,17 and 85%,19 depending on the meta-analysis. Overall rebleeding or rupture rates were 1.8%,16 1.2%,17 3%,18 and 2.5%,19 and overall thromboembolic events varied between 4.5%,16 9.8%,17 10%,18 and 17% 19.…”

Section: Woven Endobridge (Web)mentioning

confidence: 99%

“…Recently, four systematic reviews and meta-analyses regarding the use of the WEB in the acute phase of ruptured aneurysm have been published 16–19. While using similar search strategies and inclusion criteria, different studies were included in the respective reviews.…”

Section: Woven Endobridge (Web)mentioning

confidence: 99%

A mini-review of intrasaccular flow diverters

Hecker

Müller-Thies-Broussalis

Griessenauer

et al. 2022

J NeuroIntervent Surg

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Treatment of wide-necked complex intracranial aneurysms continues to challenge neurointerventionalists. Intrasaccular flow diverters have expanded the armamentarium considerably and are now used extensively. While five types of devices have already obtained the CE mark for use within Europe, only the Woven EndoBridge (WEB) device is approved by the US Food and Drug Administration. Other intrasaccular devices are the Luna/Artisse Aneurysm Embolization System (Medtronic), the Medina Embolic Device (Medtronic), the Contour Neurovascular System (Cerus), and the Neqstent Coil Assisted Flow Diverter (Cerus). This mini review will provide a compact overview of these devices and a summary of the current literature.

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The Woven EndoBridge device for ruptured intracranial aneurysms: international multicenter experience and updated meta-analysis

Cited by 18 publications

References 31 publications

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

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

Treatment of unruptured middle cerebral artery aneurysms: Systematic review in an attempt to perform a network meta-analysis

A mini-review of intrasaccular flow diverters

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