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PurposeTo determine the effect of WEB width on aneurysm occlusion after endovascular treatment of intracranial aneurysms with the Woven Endo-Bridge (WEB) device.MethodsWe retrospectively reviewed intracranial aneurysms treated with WEB without adjunctive flow-diverter or coil usage at our institution. Baseline patient and aneurysm characteristics were collected. Aneurysm occlusion at last follow-up was determined by 3 neurointerventionalists using the WEB occlusion scale. Lateral compression (LC) was determined by (1) measuring the average implanted WEB width at its equator in 2 orthogonal working projections, and (2) subtracting it from the nominal WEB width (LC = nominal - average implanted WEB width), and empirically-derived, technically-achievable adequate LC thresholds were applied (table 1). The patient cohort was categorized according to the WEB width utilized to treat the aneurysm. Univariate analysis was conducted using Chi-Square or Fisher’s Exact test.Abstract O-004 Table 1Adequate WEB lateral compression thresholds WEB Width:(mm) Adequate WEB Lateral Compression:(mm) 4 ≥0.4 5 ≥0.7 6 ≥0.96 7 ≥1.12 8 ≥1.28 9 ≥1.44 10-11 ≥1.5 Results74 aneurysms were included in our study, mean maximum aneurysm size 6.5mm (median 6.1mm, range 3.4-12.9mm), mean neck size 3.6mm, mean time to last follow-up 12.5 months. Adequate WEB LC was present in 51 aneurysms (69%), including 100% of 4mm WEBs, 68% of 5mm WEBs, 58% of 6-7mm WEBs and 53% of 8-11 WEBs. At last follow-up, complete and adequate aneurysm occlusion was present in 43 (58%) and 62 (84%) aneurysms, respectively. 8 aneurysms were retreated (11%). There was a statistically-significant lower rate of complete and adequate aneurysm occlusion for larger WEB widths (table 2), even in aneurysms with adequate WEB LC (table 3). Further, there was a statistically-significant lower rate of retreatment in aneurysms treated with 4mm and 5mm WEBs (3%) compared to 6 to 11mm WEBs (18%, p-value 0.04).Abstract O-004 Table 2Aneurysm occlusion by WEB width 4mm WEB:(N= 16) 5mm WEB:(N= 19) 6- 7mm WEB:(N= 24) 8- 11mm WEB:(N= 15) p-value: Complete occlusion,%: 100 74 29 40 < 0.0001 Adequate Occlusion,%: 100 95 79 60 0.01 Retreatment,%: 0 5 17 20 0.09 Abstract O-004 Table 3Aneurysm occlusion by WEB width in aneurysms with adequate WEB LC 4mm WEB:(N= 16) 5mm WEB:(N= 13) 6- 7mm WEB: (N= 14) 8- 11mm WEB:(N= 8) p-value: Complete Occlusion,%: 100 100 36 38 < 0.0001 Adequate Occlusion,%: 100 100 93 63 0.007 Retreatment,%: 0 0 7 13 0.37 ConclusionThe efficacy of aneurysm occlusion with WEB decreases with increasing WEB width despite attaining adequate WEB LC. Although attaining greater WEB LC when using larger WEBs, when technically-feasible, may increase the likelihood of complete and adequate aneurysm occlusion at follow-up, proper operator and patient expections should be set prior to treatment.Disclosures J. Delgado Almandoz: 2; C; Microvention/Terumo. Y. Kayan: 2; C; Microvention/Terumo. A. Copelan: None. J. Scholz: None.

Mark Kuhlberg challenges the orthodox interpretation of the relationship between the corporations which ran the Ontario's pulp and paper mills and the politicians at Queen's Park in the early twentieth century.