Multicenter Study for the Treatment of Sidewall versus Bifurcation                     Intracranial Aneurysms with Use of Woven EndoBridge (WEB)

Adeeb, Nimer; Dibas, Mahmoud; Diestro, Jose Danilo Bengzon; Cuellar‐Saenz, Hugo; Sweid, Ahmad; Kandregula, Sandeep; Lay, Sovann; Guenego, Adrien; Renieri, Leonardo; Sundararajan, Sri Hari; Saliou, Guillaume; Aslan, Assala; Möhlenbruch, Markus; Vranic, Justin E; Regenhardt, Robert W; Savardekar, Amey; Mamilly, Ahmed; Lylyk, Iván; Foreman, Paul M.; Vachhani, Jay A.; Župančić, Vedran; Hafeez, Muhammad Ubaid; Rutledge, Caleb; Waqas, Muhammad; Farinas, Carmen Parra; Tutino, Vincent M.; Inoue, Yasuaki; Mirshahi, Shervin; Rabinov, James D.; Ren, Yifan; Schirmer, Clemens M.; Piano, Mariangela; Kühn, Anna Luisa; Michelozzi, Caterina; Elens, Stéphanie; Starke, Robert M.; Hassan, Ameer E.; Salehani, Arsalaan; Sporns, Peter; Jones, Jesse; Psychogios, Marios; Spears, Julian; Lubicz, Boris; Panni, Pietro; Puri, Ajit S; Pero, Guglielmo; Griessenauer, Christoph J.; Asadi, Hamed; Stapleton, Christopher J.; Siddiqui, Adnan H.; Ducruet, Andrew F.; Albuquerque, Felipe C.; Kan, Peter; Kalousek, Vladimir; Lylyk, Pedro; Boddu, Srikanth; Knopman, Jared; Aziz-Sultan, Mohammad Ali; Limbucci, Nicola; Jabbour, Pascal; Cognard, Christophe; Dmytriw, Adam A

doi:10.1148/radiol.212006

Cited by 17 publications

(10 citation statements)

References 20 publications

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“…These two aneurysms were treated with the WEB device because they were wide necked aneurysms whose size was suitable for WEB and case reports of successfully treating PCOM and sidewall aneurysms with WEB currently exist in the literature. 11,12 Another explanation for a high rate of thromboembolic complications is if a patient population is not on sufficient antiplatelet therapy, leading to early platelet aggregation with the WEB device. However, all of our patients were prescribed dual antiplatelet therapy one week prior to the procedure.…”

Section: Discussionmentioning

confidence: 99%

Identifying risk factors for perioperative thromboembolic complications in patients treated with the Woven EndoBridge device

et al. 2022

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Introduction Woven EndoBridge (WEB) is a new endovascular treatment option for wide necked bifurcation aneurysms. Results from the WEB-IT trial showed a 0% risk of thromboembolic complications within 30 days post-op but the rate reported in the literature is as high as 10%. We are exploring potential risk factors associated with immediate thromboembolic complications in patients treated with the WEB device. Methods Retrospective study of forty-two patients with intracranial aneurysms who were treated with WEB at a single center from 2019–2021. Data was collected on patient demographics, comorbidities, aneurysm characteristics, procedural details, and hospital course. Bivariate analyses were performed to compare patients who experienced a periprocedural ischemic stroke to those who did not. Multiple logistic regression modeling was performed to identify independent risk factors for thromboembolic complications. Results Of the 42 patients that were treated with WEB, 6 suffered an ischemic stroke (AIS). These patients were more likely to have an underlying diagnosis of arrythmias (p value = 0.007). Furthermore, they had a median angle of 32.0° in the true neck view on diagnostic angiogram compared to 19.5° (p value = 0.046). Lastly, they had a longer procedure length of 228 min compared to 178 min (p value = 0.002). Patients with thromboembolic complications had a longer length of stay in the hospital and worse outcomes at three months follow up. On logistic regression modeling, these risk factors did not reach statistical significance. Conclusion Risk factors of thromboembolic complications after WEB placement include cardiac arrythmias, acute aneurysmal angle in the true neck view and a longer procedure length.

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Section: Discussionmentioning

confidence: 99%

Identifying risk factors for perioperative thromboembolic complications in patients treated with the Woven EndoBridge device

et al. 2022

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“… 47) Adeeb et al reported on the off-label use of WEB for sidewall aneurysms, noting no significant differences in complication rates between the sidewall group (2.2%) and the bifurcation group (6.6%) for thrombotic complications nor between the sidewall group (3.3%) and the bifurcation group (3.3%) for hemorrhagic complications. 48) …”

Section: Off-label Use and Sidewall Aneurysmsmentioning

confidence: 99%

Endovascular Treatment of Bifurcation Aneurysms with the Woven EndoBridge: Product Features and Selected Results of Off-Label Use

Teranishi,

Ikemura,

Arai

et al. 2024

JNET

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Treatment for wide-neck bifurcation cerebral aneurysms (WNBAs) is widely performed by endovascular treatment as well as open surgical clipping. However, due to factors such as the shape and size of the aneurysms, as well as the anatomical features of surrounding branch vessels, there are some cases in which simple coiling or conventional adjunctive techniques, such as balloon-assisted or neck bridge stent-assisted coiling, are not sufficient to achieve a satisfactory cure. Against this backdrop, the device known as the Woven EndoBridge (WEB) (MicroVention, Aliso Viejo, CA, USA) was developed and can be deployed directly into the aneurysm for treatment. Over a decade has passed since its development, and it is now used in many countries worldwide. This review provides insights into the evolution of the WEB device from its development to the date of this writing, highlighting the unique features of the device and its treatment indications. Additionally, it discusses the posttreatment course, perspectives on recurrence and retreatment, imaging assessments, and potential off-label use based on numerous studies primarily conducted in Europe and the USA.

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“…[2][3][4][5][6][7][8][9][10] Because the device is strictly endosaccular, there is no need for dual-antiplatelet treatment after WEB treatment, making it possible to treat unruptured and recurrent aneurysms as well as ruptured aneurysms. [11][12][13][14][15][16][17][18][19][20] The Clinical Assessment of the WEB Device in the Ruptured Aneurysms (CLARYS) study recently confirmed the effectiveness of the WEB device in preventing aneurysm re-rupture in ruptured aneurysms. 18 In parallel to the technical evolution of the WEB device, its indications progressively enlarged to distal and sidewall aneurysms.…”

mentioning

confidence: 99%

“…18 In parallel to the technical evolution of the WEB device, its indications progressively enlarged to distal and sidewall aneurysms. [11][12][13] Several multicenter prospective series, including WEB Clinical Assessment of Intrasaccular Aneurysm Therapy (WEBCAST), 3 WEBCAST 2, 5 French Observatory, 6 WEB Intrasaccular Therapy (WEB-IT), 10 and CLARYS, 21 have demonstrated favorable safety and efficacy of EVT with the WEB device; however, these studies were conducted before the introduction of the 17 system.…”

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confidence: 99%

Aneurysm Treatment with Woven EndoBridge-17: Angiographic and Clinical Results at 12 Months from a Retrospective, 2-Center Series

Pagano

Cortese

Soize

et al. 2023

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: This retrospective, 2-center study investigated the feasibility, safety, and efficacy at 12-month follow-up of the treatment of ruptured, unruptured, and recurrent intracranial aneurysms using the latest generation of the Woven EndoBridge (WEB) device, the WEB-17 system. MATERIALS AND METHODS:Aneurysms treated with WEB-17 were extracted from the databases of 2 neurovascular centers. Patients, aneurysm characteristics, complications, and clinical and anatomic results were analyzed. RESULTS:From February 2017 to May 2021, two hundred twelve patients with 233 aneurysms (181/233, 77.7%, unruptured-recurrent, and 52/233, 22.3%, ruptured) were included. High treatment feasibility (95.3%) was reported and was similar in ruptured aneurysms (94.2%) and unruptured-recurrent aneurysms (95.6%) (P ¼ .71) and in typical (95.4%) and atypical (94.7%) locations (P ¼ .70), but it was lower in aneurysms with an angle between the parent artery and main aneurysm axis of $45°(90.2%) compared with those with an angle of ,45°(97.1%) (P ¼ .03). Global mortality and morbidity were 1.9% and 3.8% at 1 month, respectively, and 4.4% and 1.9% at 12 months, respectively. One-month morbidity (P ¼ .02) and mortality (P ¼ .003) were higher in the ruptured group (10.0% and 8.0%, respectively) compared with unruptured-recurrent group (1.9% and 0.0%, respectively). Overall adequate occlusion (complete occlusion and neck remnant) was 86.3%. The percentage of adequate occlusion was higher (P ¼ .05) in the unruptured-recurrent group (88.5%) compared with the ruptured group (77.5%). CONCLUSIONS:The WEB-17 system showed high feasibility for ruptured and unruptured aneurysms, typical and atypical locations, and some aneurysms with an angle of $45°. As the most recent generation device, the WEB-17 also demonstrates high safety and good efficacy.

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Multicenter Study for the Treatment of Sidewall versus Bifurcation Intracranial Aneurysms with Use of Woven EndoBridge (WEB)

Cited by 17 publications

References 20 publications

Identifying risk factors for perioperative thromboembolic complications in patients treated with the Woven EndoBridge device

Identifying risk factors for perioperative thromboembolic complications in patients treated with the Woven EndoBridge device

Endovascular Treatment of Bifurcation Aneurysms with the Woven EndoBridge: Product Features and Selected Results of Off-Label Use

Aneurysm Treatment with Woven EndoBridge-17: Angiographic and Clinical Results at 12 Months from a Retrospective, 2-Center Series

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