Ten Years of Clinical Evaluation of the Woven EndoBridge: A Safe and Effective Treatment for Wide-Neck Bifurcation Aneurysms

Piérot, Laurent

doi:10.5469/neuroint.2021.00395

Cited by 14 publications

(15 citation statements)

References 51 publications

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“…At both follow-ups, the morbidity was 0.0%: no neurological signs appeared in WEB-treated patients. These results are in line with previous studies, albeit the latter focused on relatively shorter follow-up periods [ 3 , 10 , 11 ], reporting a morbidity rate ranging from 0.0% to 12% at 1-year follow-up.…”

Section: Discussionsupporting

confidence: 92%

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: Discussionsupporting

confidence: 92%

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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“…The WEB device has increased metal coverage at its base (almost 100% at its center) [ 10 ] resulting in a smooth mesh surface that diverts flow from the parent vessel away from the aneurysmal sac. Postoperatively, if no WEB protrusion is evident and no other stenting was performed, the patient may be treated with a single antiplatelet agent (aspirin) for 5 to 6 weeks, thus potentially avoiding the need for prolonged dual antiplatelet therapy [ 11 ]. These features make the WEB device a suitable treatment option for both ruptured and unruptured aneurysms [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

The Woven EndoBridge Device for the Treatment of Intracranial Aneurysms: Initial Clinical Experience within an Australian Population

Gajera¹,

Maingard²,

Foo³

et al. 2022

Neurointervention

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Purpose: Advances in endovascular technology have expanded the treatment options for intracranial aneurysms. Intrasaccular flow diversion is a relatively new technique that aims to disrupt blood inflow at the neck of the aneurysm, hence promoting intrasaccular thrombosis. The Woven EndoBridge device (WEB; MicroVention, Aliso Viejo, CA, USA) is an US Food and Drug Administration approved intrasaccular flow diverter for wide-necked aneurysms. We report the early interim clinical and radiological outcomes of patients with both ruptured and unruptured intracranial aneurysms (IAs) treated using the WEB device in an Australian population.Materials and Methods: A retrospective analysis was done of patients with ruptured or unruptured IAs who received treatment with WEB across 5 Australian neuroendovascular referral centers between May 2017 and November 2020. Angiographic occlusion was assessed with time-of-flight magnetic resonance angiography. Complications were recorded and clinical outcomes were assessed using the modified Rankin scale at follow-up.Results: In total, 66 aneurysms were treated in 63 patients, with successful deployment of the WEB device in 98.5% (n=65). Eighteen (26.9%) ruptured aneurysms were included. Failure of deployment occurred in a single case. Adjunct coiling and/or stenting was performed in 20.9% (n=14) cases. Sixty-two patients with 65 aneurysms using a WEB device were followed up (mean=9.1 months), and 89.4% of these had complete aneurysm occlusion while 1.5% remained patent. Functional independence was achieved in 93.5% of cases.Conclusion: Early results following the use of WEB devices in Australia demonstrate safety and adequate aneurysm occlusion comparable to international 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).…”

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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Ten Years of Clinical Evaluation of the Woven EndoBridge: A Safe and Effective Treatment for Wide-Neck Bifurcation Aneurysms

Cited by 14 publications

References 51 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

The Woven EndoBridge Device for the Treatment of Intracranial Aneurysms: Initial Clinical Experience within an Australian Population

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

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