Journal article
The Woven EndoBridge (WEB) device: feasibility, techniques, and outcomes after FDA approval
Journal of neurosurgery, Vol.136(5), pp.1266-1272
05/01/2022
DOI: 10.3171/2021.5.JNS21889
PMID: 34624864
Abstract
OBJECTIVE Wide-neck bifurcation cerebral aneurysms have historically required either clip ligation or stent- or balloon-assisted coil embolization. This predicament led to the development of the Woven EndoBridge (WEB) aneurysm embolization system, a self-expanding mesh device that achieves intrasaccular flow disruption and does not require antithrombotic medications. The authors report their operative experience and 6-month follow-up occlusion outcomes with the first 115 aneurysms they treated via WEB embolization. METHODS The authors reviewed the first 115 cerebral aneurysms they treated by WEB embolization after FDA approval of the WEB embolization device (from February 2019 to January 2021). Data were collected on patient demographics and clinical presentation, aneurysm characteristics, procedural details, postembolization angiographic contrast stasis, and functional outcomes. RESULTS A total of 110 patients and 115 aneurysms were included in our study (34 ruptured and 81 unruptured aneurysms). WEB embolization was successful in 106 (92.2%) aneurysms, with a complication occurring in 6 (5.5%) patients. Contrast clearance was seen in the arterial phase in 14 (12.2%) aneurysms, in the capillary phase in 16 (13.9%), in the venous phase in 63 (54.8%), and no contrast was seen in 13 (11.3%) of the aneurysms studied. Follow-up angiography was performed on 60 (52.6%) of the aneurysms, with complete occlusion in 38 (63.3%), neck remnant in 14 (23.3%), and aneurysmal remnant in 8 (13.3%). Six (5.5%) patients required re-treatment for persistent aneurysmal residual on follow-up angiography. CONCLUSIONS The WEB device has been successfully used for the treatment of both unruptured and ruptured wide-neck bifurcation aneurysms by achieving intrasaccular flow diversion. Here, the authors have shared their experience with its unique technical considerations and device size selection, as well as critically reviewed complications and aneurysm occlusion rates.
Details
- Title: Subtitle
- The Woven EndoBridge (WEB) device: feasibility, techniques, and outcomes after FDA approval
- Creators
- Nikolaos Mouchtouris - Thomas Jefferson University HospitalDavid Hasan - University of IowaEdgar A. Samaniego - University of IowaFadi Al SaieghAhmad Sweid - Thomas Jefferson University HospitalRawad Abbas - Thomas Jefferson University HospitalKareem El NaamaniRizwan Tahir - Thomas Jefferson University HospitalMario Zanaty - University of IowaOmaditya Khanna - Thomas Jefferson University HospitalNohra Chalouhi - Thomas Jefferson University HospitalStavropoula Tjoumakaris - Thomas Jefferson University HospitalM. Reid Gooch - Thomas Jefferson University HospitalRobert Rosenwasser - Thomas Jefferson University HospitalPascal Jabbour
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.136(5), pp.1266-1272
- DOI
- 10.3171/2021.5.JNS21889
- PMID
- 34624864
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Language
- English
- Date published
- 05/01/2022
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984526207302771
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