International Study of Intracranial Aneurysm Treatment Using Woven EndoBridge: Results of the WorldWideWEB Consortium

Dmytriw, Adam A.; Diestro, Jose Danilo Bengzon; Dibas, Mahmoud; Phan, Kevin; Sweid, Ahmad; Cuellar‐Saenz, Hugo; Lay, Sovann; Guenego, Adrien; Renieri, Leonardo; Balushi, Ali Al; Sundararajan, Sri Hari; Carnevale, Joseph A.; Saliou, Guillaume; Möhlenbruch, Markus; Vranic, Justin E; Harker, Pablo; Rabinov, James D.; Lylyk, Iván; Foreman, Paul M.; Vachhani, Jay A.; Župančić, Vedran; Hafeez, Muhammad Ubaid; Rutledge, Caleb; Waqas, Muhammad; Tutino, Vincent M.; Abbas, Rawad; Inoue, Yasuaki; Capirossi, Carolina; Ren, Yifan; Schirmer, Clemens M.; Piano, Mariangela; Kühn, Anna Luisa; Michelozzi, Caterina; Elens, Stéphanie; Regenhardt, Robert W; Ghozy, Sherief; Alotaibi, Naif M.; Tjoumakaris, Stavropoula; Starke, Robert M.; Lubicz, Boris; Panni, Pietro; Puri, Ajit S; Pero, Guglielmo; Griessenauer, Christoph J.; Ulfert, Christian; Asadi, Hamed; Brooks, Mark; Maingard, Julian; Jhamb, Ashu; Siddiqui, Adnan H.; Ducruet, Andrew F; Albuquerque, Felipe C.; Kan, Peter; Kalousek, Vladimir; Lylyk, Pedro; Savardekar, Amey; Boddu, Srikanth; Knopman, Jared; Limbucci, Nicola; Chen, Karen S.; Aziz-Sultan, Mohammad Ali; Stapleton, Christopher J.; Jabbour, Pascal; Cognard, Christophe; Adeeb, Nimer

doi:10.1161/strokeaha.121.037609

Cited by 22 publications

(15 citation statements)

References 2 publications

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“…There is an ongoing pragmatic randomized controlled trial on using the WEB device for both ruptured and unruptured aneurysms 7. While awaiting the results from this trial, we aim to study the radiologic and clinical outcomes of patients with ruptured aneurysms compared with unruptured aneurysms treated with the WEB device, using data from an international multicenter consortium 8…”

Section: Introductionmentioning

confidence: 99%

Intrasaccular flow disruption for ruptured aneurysms: an international multicenter study

Diestro

Dibas

Adeeb

et al. 2022

J NeuroIntervent Surg

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BackgroundThe Woven EndoBridge (WEB) device is a novel intrasaccular flow disruptor tailored for bifurcation aneurysms. We aim to describe the degree of aneurysm occlusion at the latest follow-up, and the rate of complications of aneurysms treated with the WEB device stratified according to rupture status.MethodsOur data were taken from the WorldWideWeb Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups: ruptured and unruptured. We compared clinical and radiologic outcomes of both groups. Propensity score matching (PSM) was done to match according to age, gender, bifurcation, location, prior treatment, neck, height, dome width, daughter sac, incorporated branch, pretreatment antiplatelets, and last imaging follow-up.ResultsThe study included 676 patients with 691 intracranial aneurysms (529 unruptured and 162 ruptured) treated with the WEB device. The PSM analysis had 55 pairs. In both the unmatched (85.8% vs 84.3%, p=0.692) and matched (94.4% vs 83.3%, p=0.066) cohorts there was no significant difference in the adequate occlusion rate at the last follow-up. Likewise, there were no significant differences in both ischemic and hemorrhagic complications between the two groups. There was no documented aneurysm rebleeding after WEB device implantation.ConclusionThere was no significant difference in both the radiologic outcomes and complications between unruptured and ruptured aneurysms. Our findings support the feasibility of treatment of ruptured aneurysms with the WEB device.

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Section: Introductionmentioning

confidence: 99%

Intrasaccular flow disruption for ruptured aneurysms: an international multicenter study

Diestro

Dibas

Adeeb

et al. 2022

J NeuroIntervent Surg

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“…Crinnion et al reported use of adjunctive devices in 4% of cases, suggesting that the WEB can be used effectively for ruptured wide-necked aneurysms as standalone therapy 17. The recently published WorldWideWEB Consortium study with 683 retrospectively analyzed aneurysms showed similar occlusion, retreatment and thromboembolic complication rates (57.8% complete, 85.7% adequate occlusion, 7.8% retreatment, and 7.5% thromboembolic complication rate) 20…”

Section: Woven Endobridge (Web)mentioning

confidence: 98%

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 WEB device is a self-expanding, retrievable, electrothermally detachable braided nitinol device that is placed within the aneurysm sac (67). It disrupts blood flow at the aneurysm neck and induces intra-aneurysmal thrombosis and offers a flat proximal surface that potentially supports the neoendothelium (68). In general, the WEB device in the aneurysm sac obviates the need for potent antiplatelet therapy if it does not protrude into the parent artery, which makes the WEB device appealing for ruptured and unruptured aneurysms (69).…”

Section: Woven Endobridge (Web) Devicementioning

confidence: 99%

Endovascular treatment of aneurysms of the paraophthalmic segment of the internal carotid artery: Current status

Wang

2022

Front. Neurol.

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The paraophthalmic segment of the internal carotid artery (ICA) originates from the distal border of the cavernous ICA and terminates at the posterior communicating artery. Aneurysms arising from the paraophthalmic segment represent ~5–10% of intradural aneurysms. Due to the advent of endovascular treatment (EVT) techniques, specifically flow-diverting stents (FDSs), EVT has become a good option for these aneurysms. A literature review on EVT for paraophthalmic segment aneurysms is necessary. In this review, we discuss the anatomy of the paraophthalmic segment, classification of the paraophthalmic segment aneurysms, EVT principle and techniques, and prognosis and complications. EVT techniques for paraophthalmic segment aneurysms include coil embolization, FDSs, covered stents, and Woven EndoBridge devices. Currently, coiling embolization remains the best choice for ruptured paraophthalmic segment aneurysms, especially to avoid long-term antiplatelet therapy for young patients. Due to the excessive use of antiplatelet therapy, unruptured paraophthalmic segment aneurysms that are easy to coil should not be treated with FDS. FDS is appropriate for uncoilable or failed aneurysms. Other devices cannot act as the primary choice but can be useful auxiliary tools. Both coiling embolization and FDS deployment can result in a good prognosis for paraophthalmic segment aneurysms. The overall complication rate is low. Therefore, EVT offers promising treatments for paraophthalmic segment aneurysms. In addition, surgical clipping continues to be a good choice for paraophthalmic segment aneurysms in the endovascular era.

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International Study of Intracranial Aneurysm Treatment Using Woven EndoBridge: Results of the WorldWideWEB Consortium

Cited by 22 publications

References 2 publications

Intrasaccular flow disruption for ruptured aneurysms: an international multicenter study

Intrasaccular flow disruption for ruptured aneurysms: an international multicenter study

A mini-review of intrasaccular flow diverters

Endovascular treatment of aneurysms of the paraophthalmic segment of the internal carotid artery: Current status

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