Efficacy and Safety of the Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis
- PMID: 27516237
- PMCID: PMC7963876
- DOI: 10.3174/ajnr.A4900
Efficacy and Safety of the Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis
Abstract
Background and purpose: Intrasaccular flow diverters are increasingly being used in the treatment of wide-neck and bifurcation aneurysms. We performed a systematic review and meta-analysis of existing literature on the Woven EndoBridge device in the treatment of intracranial aneurysms.
Materials and methods: A comprehensive literature search was performed through October 1, 2015. We extracted information on baseline aneurysm and patient characteristics. Outcomes studied included immediate and midterm (>3 month) angiographic outcomes (complete occlusion as well as adequate occlusion, defined as complete occlusion or neck remnant), aneurysm retreatment, intraoperative rupture, perioperative morbidity and mortality, thromboembolic complications, and treatment failure. Meta-analysis was performed by using the random-effects model.
Results: Fifteen uncontrolled series were included in this analysis, including 565 patients with 588 aneurysms, of which 127 were ruptured. Initial complete and adequate occlusion rates were 27% (95% CI, 15%-39%) and 59% (95% CI, 39%-78%), respectively. Midterm complete and adequate occlusion rates after a median of 7 months were 39% (95% CI, 26%-52%) and 85% (95% CI, 78%-91%), respectively. Perioperative morbidity and mortality rates were 4% (95% CI, 1%-8%) and 1% (95% CI, 0%-2%), respectively. Midterm adequate occlusion rates for ruptured aneurysms were 85% (95% CI, 67%-98%), compared with 84% (95% CI, 72%-94%) for unruptured aneurysms (P = .89). Patients with ruptured aneurysm had similar rates of perioperative morbidity to patients with unruptured aneurysm (2%; 95% CI, 0%-26% versus 2%; 95% CI, 0%-6%, respectively; P = .35).
Conclusions: Early evidence derived from uncontrolled studies suggests that Woven EndoBridge treatment has a good safety profile and promising rates of adequate occlusion, especially given the complexity of aneurysms treated. Further prospective clinical trials are needed to confirm these results and better define the risks and benefits of use of the Woven EndoBridge device in treating wide-neck and wide-neck bifurcation aneurysms.
© 2016 by American Journal of Neuroradiology.
Figures
Comment in
-
Reply.AJNR Am J Neuroradiol. 2017 Jan;38(1):E8. doi: 10.3174/ajnr.A4987. Epub 2016 Oct 13. AJNR Am J Neuroradiol. 2017. PMID: 27737855 Free PMC article. No abstract available.
-
More Transparency Is Needed in the Reporting of Clinical Research Studies.AJNR Am J Neuroradiol. 2017 Jan;38(1):E6-E7. doi: 10.3174/ajnr.A4982. Epub 2016 Oct 13. AJNR Am J Neuroradiol. 2017. PMID: 27737856 Free PMC article. No abstract available.
Similar articles
-
The Woven Endobridge Device for Treatment of Intracranial Aneurysms: A Systematic Review.World Neurosurg. 2017 Feb;98:809-817.e1. doi: 10.1016/j.wneu.2016.11.020. Epub 2016 Nov 14. World Neurosurg. 2017. PMID: 27856383
-
Treatment of ruptured intracranial aneurysms with the Woven EndoBridge device: a systematic review.J Neurointerv Surg. 2022 Apr;14(4):366-370. doi: 10.1136/neurintsurg-2021-017613. Epub 2021 Jul 15. J Neurointerv Surg. 2022. PMID: 34266907
-
Safety and efficacy of the Woven EndoBridge (WEB) device in ruptured intracranial aneurysms: a systematic review and updated meta-analysis.Neuroradiology. 2025 Jul;67(7):1859-1872. doi: 10.1007/s00234-025-03677-z. Epub 2025 Jun 16. Neuroradiology. 2025. PMID: 40522486 Review.
-
Endovascular Treatment of Intracranial Aneurysms with the WEB Device: A Systematic Review of Clinical Outcomes.AJNR Am J Neuroradiol. 2016 May;37(5):868-72. doi: 10.3174/ajnr.A4611. Epub 2015 Nov 19. AJNR Am J Neuroradiol. 2016. PMID: 26585260 Free PMC article.
-
Defining ideal middle cerebral artery bifurcation aneurysm size for Woven EndoBridge embolization.J Neurosurg. 2024 Oct 11;142(3):647-657. doi: 10.3171/2024.5.JNS232204. Print 2025 Mar 1. J Neurosurg. 2024. PMID: 39393093
Cited by
-
Shape Modification is Common in Woven EndoBridge-Treated Intracranial Aneurysms: A Longitudinal Quantitative Analysis Study.AJNR Am J Neuroradiol. 2020 Sep;41(9):1652-1656. doi: 10.3174/ajnr.A6669. Epub 2020 Jul 30. AJNR Am J Neuroradiol. 2020. PMID: 32732267 Free PMC article.
-
The New Low-Profile WEB 17 System for Treatment of Intracranial Aneurysms: First Clinical Experiences.AJNR Am J Neuroradiol. 2018 May;39(5):859-863. doi: 10.3174/ajnr.A5608. Epub 2018 Mar 22. AJNR Am J Neuroradiol. 2018. PMID: 29567650 Free PMC article.
-
Embolization of Ruptured and Unruptured Aneurysms with the Contour Neurovascular System-Summary of 106 Cases.AJNR Am J Neuroradiol. 2025 Apr 2;46(4):698-705. doi: 10.3174/ajnr.A8606. AJNR Am J Neuroradiol. 2025. PMID: 40147835
-
Initial experiences of the Optima™ coil system in intracranial aneurysm treatment: surgical and interventional approach to safety and efficacy in terms of cerebral arteries.Acta Cir Bras. 2025 May 9;40:e403425. doi: 10.1590/acb403425. eCollection 2025. Acta Cir Bras. 2025. PMID: 40366986 Free PMC article.
-
Intracranial aneurysm treatment with WEB and adjunctive stent: preliminary evaluation in a single-center series.J Neurointerv Surg. 2022 Feb;14(2):164-168. doi: 10.1136/neurintsurg-2021-017379. Epub 2021 Mar 30. J Neurointerv Surg. 2022. PMID: 33785641 Free PMC article.
References
-
- Moret J, Cognard C, Weill A, et al. . The “remodelling technique” in the treatment of wide neck intracranial aneurysms: angiographic results and clinical follow-up in 56 cases. Interv Neuroradiol 1997;3:21–35 - PubMed
-
- Mu SQ, Yang XJ, Li YX, et al. . Endovascular treatment of wide-necked intracranial aneurysms using of “remodeling technique” with the HyperForm balloon. Chin Med J (Engl) 2008;121:725–29 - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical