WEB Intrasaccular Flow Disruptor—Prospective, Multicenter Experience in 83 Patients with 85 Aneurysms

Abstract

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.

Intrasaccular Flow Disruption in Acutely Ruptured Aneurysms: A Multicenter Retrospective Review of the Use of the WEB

“…For comparison, the treatment morbidity and mortality rates were 1.3% and 0.0% in the Papagiannaki et al series, 1.7% and 1.4% in ATENA, and 3.7% and 1.5% in CLARITY, respectively. [20][21][22] Between the 2 different types of WEB devices (single-or duallayer), not many differences could be found. First, because of the later introduction of the WEB-SL, all treatments before June 2013 were performed with the WEB-DL.…”

“…18 Therefore, thromboembolic events are of special concern, accepting that subarachnoid hemorrhage is known to induce a hypercoagulative state. 19 Recently, a multicenter study by Papagiannaki et al 20 of 87 aneurysms (mostly unruptured) in 85 patients was published, and the results were favorable for the WEB when compared with those of coil occlusion in the Analysis of Treatment by Endovascular Approach of Nonruptured Aneurysms (ATENA) trial and the Clinical and Anatomical Results In the Treatment of Ruptured Intracranial Aneurysms (CLARITY) study. 21,22 Although the percentage of broad-based aneurysms was much higher in the Papagiannaki et al series (85.9% vs 9.1% in CLARITY), the results for peri-interventional rupture and thromboembolic events were comparably low, and the rate of adequate occlusion was even higher with WEB than in CLARITY.…”

Flow-Diverter Stents for the Treatment of Saccular Middle Cerebral Artery Bifurcation Aneurysms

“…The WEB device is intended for the treatment of the same population as seen in our study. Some midterm follow-up studies have been published 17,31,32 and show good safety with morbidity rates of between 1.3% and 3.1%, with no mortality reported. Midterm anatomic results 17,31,33 have shown complete occlusion in 26.7%-56.9% of aneurysms.…”

WEB Treatment of Intracranial Aneurysms: Clinical and Anatomic Results in the French Observatory

“…Treatment with the WEB has been evaluated in several retrospective series showing good safety results. [10][11][12][13] In addition, midterm and long-term anatomic results have been evaluated in retrospective series showing good stability of the treatment. 14,15 To have a more rigorous evaluation of the safety and efficacy, 2 prospective, Good Clinical Practice series were initiated simultaneously in Europe (WEB Clinical Assessment of IntraSaccular Aneurysm Therapy [WEBCAST]) and in France (French Observatory).…”