Aneurysm treatment with the Woven EndoBridge (WEB) device in the combined population of two prospective, multicenter series: 5-year follow-up

• DOI: 10.1136/neurintsurg-2021-018414
• Publication Date: 2022-07-08T17:25:35Z
• Authors: Laurent Pierot; Istvan Szikora; Xavier Barreau; Markus Holtmannsp...; Laurent Spelle; Joachim Klisch; Denis Herbreteau; Vincent Costalat; Jens Fiehler; Anne-Christine Ja...; Thomas Liebig; Luc Stockx; Werner Weber; Joachim Berkefeld; Jacques Moret; Andy Molyneux; James Byrne
• Keywords: Endovascular Procedures; Intracranial Aneurysm; Embolization, Therapeutic; 3. Good health; Hemorrhagic Stroke; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Humans; Prospective Studies; Follow-Up Studies; Retrospective Studies

BackgroundEvaluating a new endovascular treatment for intracranial aneurysms must not only demonstrate short-term safety and efficacy, but also evaluate longer-term outcomes (eg, delayed complications, anatomical results, retreatment). The current analysis reports the 5-year clinical and anatomical results of Woven EndoBridge (WEB) treatment in two European combined trial populations (WEBCAST (WEB Clinical Assessment of Intrasaccular Aneurysm Therapy) and WEBCAST-2).MethodsAll adverse events occurring between the procedure and 5-year follow-up were independently evaluated by an expert. Aneurysm occlusion was evaluated by an independent core laboratory using a three-grade scale: complete occlusion, neck remnant, and aneurysm remnant. In cases where data were not available at 5-year follow-up, the last observation carry forward (LOCF) method was used.ResultsThe safety and efficacy populations comprised 100 patients and 95 aneurysms, respectively. No adverse event related to the device occurred after the procedure during the 5-year follow-up period. Mortality at 5 years was 7.0% (7/100 patients) including mortality related to the WEB (0/100, 0.0%), the procedure (1/100, 1.0%), and another condition (6/100, 6.0%). At 5 years, complete aneurysm occlusion was observed in 49/95 (51.6%) aneurysms, neck remnant in 25/95 (26.3%), and aneurysm remnant in 21/95 (22.1%). Retreatment rate at 5 years was 11.6% (11/95 aneurysms).ConclusionsThis analysis conducted in a population of patients with wide-neck bifurcation aneurysms confirms WEB’s safety profile. Additional evidence demonstrates good stability of aneurysm occlusion with adequate occlusion (complete occlusion or neck remnant) at 5 years in 77.9% of aneurysms with a low retreatment rate (11.6%).Clinical trial registrationWEBCAST and WEBCAST-2: Unique identifier:NCT01778322.