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

• Published in: Neurosurgery Vol. 87; no. 2; pp. 357 - 367
• Main Authors: Pierot, Laurent, Moret, Jacques, Barreau, Xavier, Szikora, Istvan, Herbreteau, Denis, Turjman, Francis, Holtmannspötter, Markus, Januel, Anne-Christine, Costalat, Vincent, Fiehler, Jens, Klisch, Joachim, Gauvrit, Jean-Yves, Weber, Werner, Desal, Hubert, Velasco, Stéphane, Liebig, Thomas, Stockx, Luc, Berkefeld, Joachim, Molyneux, Andrew, Byrne, James V, Spelle, Laurent
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.08.2020; Copyright by the Congress of Neurological Surgeons; Wolters Kluwer Health, Inc; Lippincott, Williams & Wilkins
• Subjects: Adult; Aged; Anatomy & physiology; Aneurysms; Brain surgery; Care and treatment; Editor's Choice; Embolization, Therapeutic; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Endoscopy; Endovascular Procedures; Endovascular Procedures - instrumentation; Endovascular Procedures - methods; Europe; Female; Follow-Up Studies; Humans; Intracranial Aneurysm; Intracranial Aneurysm - therapy; Life Sciences; Male; Medical research; Medicine, Experimental; Middle Aged; Neurons and Cognition; Pharmaceutical sciences; Prospective Studies; Research—Human—Clinical Studies; Surgical outcomes; Surgical techniques; Treatment Outcome; Vascular surgery; Europe; France; Germany; California; Aneurysms; Endovascular treatment; Flow disruption; WEB device
• ISSN: 0148-396X; 1524-4040
• DOI: 10.1093/neuros/nyz557

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%). Graphical Abstract Graphical Abstract