The Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: Ten Years of Lessons Learned and Adjustments in Practice from the WorldWideWEB Consortium

Adam A. Dmytriw, Mahmoud Dibas, Sherief Ghozy, Nimer Adeeb, Jose Danilo Bengzon Diestro, Kevin Phan, Hugo H. Cuellar-Saenz, Ahmad Sweid, Sovann V. Lay, Adrien Guenego, Leonardo Renieri, Ali Al Balushi, Guillaume Saliou, Markus Möhlenbruch, Robert W. Regenhardt, Justin E. Vranic, Ivan Lylyk, Paul M. Foreman, Jay A. Vachhani, Vedran ŽupančićMuhammad U. Hafeez, Caleb Rutledge, Muhammad Waqas, Vincent M. Tutino, James D. Rabinov, Yifan Ren, Clemens M. Schirmer, Mariangela Piano, Anna L. Kühn, Caterina Michelozzi, Stéphanie Elens, Robert M. Starke, Ameer Hassan, Arsalaan Salehani, Peter Sporns, Jesse Jones, Marios Psychogios, Julian Spears, Boris Lubicz, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Christoph J. Griessenauer, Hamed Asadi, Christopher J. Stapleton, Adnan Siddiqui, Andrew F. Ducruet, Felipe C. Albuquerque, Rose Du, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Stavropoula Tjoumakaris, Jared Knopman, Mohammad A. Aziz-Sultan, Nicola Limbucci, Pascal Jabbour, Christophe Cognard, Aman B. Patel

Research output: Contribution to journalArticlepeer-review

Abstract

Several studies have shown promising outcomes of the Woven EndoBridge (WEB) device for the treatment of wide-necked intracranial bifurcation aneurysms. This is a multicenter study attempts to explore the changes in trends and treatment outcomes over time for WEB embolization of intracranial aneurysms. The WorldWideWEB consortium is a retrospective multicenter collaboration of data from international centers spanning from January 2011 and June 2021, with no limitations on aneurysm location or rupture status. Both bifurcation and sidewall aneurysms were included. These patients were stratified based on treatment year into five treatment intervals: 2011–2015 (N = 66), 2016–2017 (N = 77), 2018 (N = 66), 2019 (N = 300), and 2020–2021 (N = 173). Patient characteristics and angiographic and clinical outcomes were compared between these time intervals. This study comprised 671 patients (median age 61.4 years; 71.2% female) with 682 intracranial aneurysms. Over time, we observed an increasing tendency to treat patients presenting with ruptured aneurysms and aneurysms with smaller neck, diameter, and dome widths. Furthermore, we observed a trend towards more off-label use of the WEB for sidewall aneurysms and increased adoption of transradial access for WEB deployment. Moreover, the proportion of patients with adequate WEB occlusion immediately and at last follow-up was significantly higher in more recent year cohorts, as well as lower rates of compaction and retreatment. Mortality and complications did not differ over time. This learning curve study suggests improved experience using the WEB for the treatment of intracranial aneurysms and has yielded higher rates of adequate occlusion over time.

Original languageEnglish (US)
Pages (from-to)455-464
Number of pages10
JournalTranslational Stroke Research
Volume14
Issue number4
DOIs
StatePublished - Aug 2023
Externally publishedYes

Keywords

  • Endovascular
  • Intracranial aneurysm
  • Intrasaccular
  • Learning curve
  • WEB
  • Woven EndoBridge

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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