The Woven Endobridge as a treatment for acutely ruptured aneurysms: A review of the literature

Abstract

The Woven Endobridge (WEB; Microvention, Aliso Viejo, California, USA) is a relatively new device which has been shown to be safe and effective for the treatment of wide necked bifurcation aneurysms in multiple prospective Good Clinical Practice studies. However, the vast majority of aneurysms included in these studies have been unruptured. The aim of this review is to summarise the current evidence available on the treatment of ruptured aneurysms with the WEB.

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

“…As such, the WEB can be used to treat un- ruptured and ruptured aneurysms. 16,17,[21][22][23][24][25][26][27] To date, the four European GCP studies and the USA have included a relatively small number of ruptured aneurysms: 6.0% in WEB-IT and 8.3% in the three European GCP studies. 16,17 Several series and meta-analyses have recently focused on ruptured aneurysm management with WEB, showing its good efficacy in preventing rebleeding (see below).…”

“…16,17 Several series and meta-analyses have recently focused on ruptured aneurysm management with WEB, showing its good efficacy in preventing rebleeding (see below). [21][22][23][24][25][26][27] In a recent meta-analysis, Essibayi et al 27 reported a rate of late rebleeding of 1.1%. Yet, there have been very few studies analyzing the role of WEB treatment versus other EVT techniques when managing ruptured aneurysms.…”

“…With a rate of 0.0% in most series, results have shown the WEB device's high efficacy in preventing early rebleeding. [21][22][23][24] In the Crinnion et al 25 literature review, the rerupture rate after WEB treatment of ruptured aneurysms in 247 patients was 1.2% (the follow-up period was not specified). In the Harker et al 24 meta-analysis (309 WEB treatments), the rate of rebleeding was 2.5%.…”

Adjustment of Malpositioned Woven EndoBridge Device Using Gooseneck Snare: Complication Management Technique

“…In our case, the decision to use a WEB over other forms of embolization was based on our belief that the WEB would require less procedural time along with promising results from recent literature examining the WEB in acutely ruptured cases and sidewall and communicating segment ICA aneurysms (note however, the time gained with a single WEB device was likely conceded due to the eventual time that retrieval mandated, which was obviously unintentional and unknown prior to treatment). [6][7][8][9] Goertz et al 7 showed complete occlusion in 76.5% of ICA sidewall aneurysms treated with WEB, without procedure-related morbidity or mortality, while Aguiar et al 8 showed a high safety profile for WEB devices when used in off-label indications such as posterior communicating artery aneurysms. While primary coil embolization, balloon-assisted coil embolization, and open surgical clipping were also considered as reasonable treatment options, we felt that WEB embolization was, at a minimum, not inferior to those techniques.…”

A mini-review of intrasaccular flow diverters

“…Recently, four systematic reviews and meta-analyses regarding the use of the WEB in the acute phase of ruptured aneurysm have been published 16–19. While using similar search strategies and inclusion criteria, different studies were included in the respective reviews.…”