Aneurysm Treatment With Woven EndoBridge in the Cumulative Population of 3 Prospective, Multicenter Series: 2-Year Follow-Up

Abstract

BACKGROUND Woven EndoBridge (WEB; Sequent Medical) treatment is an innovative endovascular approach for treatment of wide-neck bifurcation aneurysms. Initial studies have shown high safety with good efficacy at short term confirmed by trials conducted in United States (WEB-Intrasaccular Therapy) and in Europe (WEB Clinical Assessment of Intrasaccular Aneurysm Therapy [WEBCAST], French Observatory, and WEBCAST-2). OBJECTIVE To report the 2-yr clinical and anatomical results of WEB treatment in the combined population of 3 European trials. METHODS In a French Observatory, 2-yr clinical and anatomical data were collected. In WEBCAST and WEBCAST-2, 2-yr follow-up was optional, and data were collected when follow-up was performed. Aneurysm occlusion was evaluated using a 3-grade scale: complete occlusion, neck remnant, and aneurysm remnant. RESULTS The population for safety was 138/168 patients (82.1%), including 89 females (64.5%), with mean age of 55.5 ± 10.2 yr. The population for efficacy was 121/169 aneurysms (71.6%). Aneurysm locations were middle cerebral artery in 65/121 aneurysms (53.7%), anterior-communicating artery in 25/121 (20.7%), basilar artery in 17/121 (14.0%), and internal carotid artery terminus in 14/121 (11.6%). No clinically relevant adverse events occurred between years 1 and 2. At 2 yr, complete occlusion was observed in 62/121 (51.2%) aneurysms, neck remnant in 36/121 (29.8%) aneurysms, and aneurysm remnant in 23/121 (19.0%) aneurysms. The global retreatment rate at 2 yr was 9.3%. CONCLUSION This analysis confirms the high safety profile of WEB treatment at 2 yr. Aneurysm occlusion is generally stable at 2 yr, and the retreatment rate between 1 yr and 2 yr is low (2.0%).

Endovascular treatment of basilar tip aneurysms in the era of endosaccular flow disruption: a comparative study

“…The rate of clinically relevant thromboembolic events was higher in the coiling group (17%) than in the EFD group (4%), however without statistical significance (P = 0.3). The thromboembolic complication rate in the EFD group was in compliance with the literature [3][4][5][6][7].…”

“…The WEB and Contour devices represent a completely different concept: different from stents and intraluminal flow diverter stents, these dense-meshed devices are placed completely in the aneurysm sac and aim to disrupt the blood flow entering and exiting the sac at the level of the neck in order to promote stagnation and thrombus formation. The WEB device proved efficacy and safety in multiple prospective and retrospective multi-centred studies, especially in the treatment of ruptured and wide-necked aneurysms [3][4][5][6][7].…”

“…The Woven EndoBridge (WEB; Microvention/Terumo, Aliso Viejo, CA, USA) is deployed completely endosaccular in order to reduce the inflow into the aneurysm at the level of the neck, thus leading to thrombus formation and potentially shrinkage of the aneurysm sac. The technical success and safety of WEB was supported by several studies resulting in widespread use for both ruptured and unruptured aneurysms [3][4][5][6][7].…”

Endovascular treatment for aneurysms at the A1 segment of the anterior cerebral artery: current difficulties and solutions

“…Though, compared to its counterparts in other intracranial locations, the A1 aneurysm often presents a more complicated entity during EVT, the development of some new devices might help to simplify the treatment [72]. Among these new devices, flow-diverting device (FDD) and the Woven EndoBridge (WEB, Sequent Medical, Aliso Viejo, California, USA) device are the most promising devices [73].…”

“…The WEB is an innovative device for wide-neck bifurcation aneurysms. It has been recently reported to be a safe and effective option for both ruptured and unruptured wide-neck aneurysms in different intracranial sites [73,76,77]. After placement of a WEB device within the aneurysm sac, it can seal the aneurysm neck leaving the parent artery unaffected [78].…”