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Long-Term Outcomes of the WEB Device for Treatment of Wide-Neck Bifurcation Aneurysms

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With a mean follow-up of approximately 15 months, the authors evaluated 41 cases of wide-neck aneurysms. Overall, 78.8% of the aneurysms had complete occlusion in the last follow-up, and 19.5%… Click to show full abstract

With a mean follow-up of approximately 15 months, the authors evaluated 41 cases of wide-neck aneurysms. Overall, 78.8% of the aneurysms had complete occlusion in the last follow-up, and 19.5% required retreatment with additional endovascular devices. A good clinical outcome (mRS: 0–2) was obtained in 95.1% of the patients, and the overall treatment-related morbidity and mortality rates were 2.4% and 0.0%, respectively. They conclude that treatment of wide-neck bifurcation aneurysms with a WEB device is feasible with an acceptable safety and efficacy rate. BACKGROUND AND PURPOSE: Treatment of wide-neck bifurcation aneurysms using endovascular therapy is still challenging even with the development of treatment devices. The purpose of this investigation was to assess the safety and efficacy of treatment with a Woven EndoBridge (WEB) device for wide-neck bifurcation aneurysms. MATERIALS AND METHODS: All patients treated with a WEB device at our institution between May 2009 and November 2016 were retrospectively evaluated. Clinical and imaging evaluation, aneurysm occlusion status, and modified Rankin scale score were analyzed 1 day after treatment and in the short- (<6 months), mid- (<24 months), and long-term (>24 months) follow-up periods. RESULTS: Forty-one cases of wide-neck aneurysms were analyzed in this study. Overall, 78.8% of the aneurysms had complete occlusion in the last follow-up, and 19.5% required retreatment with additional endovascular devices. A good clinical outcome (modified Rankin scale: 0–2) was obtained in 95.1% of the patients, and the overall treatment-related morbidity and mortality rates were 2.4% and 0.0%, respectively. The mean follow-up time was 15.3 ± 13.5 months. CONCLUSIONS: The results obtained in this study suggest that treatment of wide-neck bifurcation aneurysms with a WEB device is feasible with an acceptable safety and efficacy rate.

Keywords: wide neck; web device; neck bifurcation; bifurcation aneurysms; treatment

Journal Title: American Journal of Neuroradiology
Year Published: 2020

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