Journal Article

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

Januel, Anne-Christine, Velasco, Stéphane, Gauvrit, Jean-Yves, Desal, Hubert, Holtmannspötter, Markus, Moret, Jacques, Turjman, Francis, Stockx, Luc, Pierot, Laurent, Barreau, Xavier, Costalat, Vincent, Liebig, Thomas, Klisch, Joachim, Molyneux, Andrew, Szikora, Istvan, Herbreteau, Denis, Byrne, James V, Berkefeld, Joachim, Spelle, Laurent, Weber, Werner, Fiehler, Jens

2020

Overview

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

• Publisher: Oxford University Press,Copyright by the Congress of Neurological Surgeons,Wolters Kluwer Health, Inc,Lippincott, Williams & Wilkins
• Subject: 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