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Efficiency and complications of Woven EndoBridge (WEB) devices for treatment of larger, complex intracranial aneurysms—a single-center experience

  • Original Article - Vascular Neurosurgery - Aneurysm
  • Published:
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Abstract

Background

Several recently published multicenter studies have reported high treatment feasibility, high safety, and good 6-month to 1-year efficiency when treating smaller intracranial aneurysms (IA) with WEB deployment. The purpose of the study was to evaluate the long-term efficiency and complications related to WEB treatment of larger, complex intracranial aneurysms in a small single-center cohort.

Methods

Patients with ruptured and unruptured IA were treated with WEB devices; data were collected prospectively and analyzed retrospectively. The study evaluates complications and clinical and radiological findings at immediate and last available follow-up.

Results

The study included 16 patients with 16 aneurysms and a median follow-up time of 36 months, range 13–49 months; 9/16 were females. Median age 59 with range 39–71 years. Mean aneurysm size 11.3 ± 1.7 mm, predominant location at the basilar artery bifurcation and anterior communicating artery. Three out of sixteen IAs were ruptured. Even though 75% of the IAs were immediately occluded completely, retreatment was eventually necessary in 7/15 (46.7%). Increasing neck remnants and recurrences were mainly observed past 1-year follow-up. The WEB device showed modifications over time, with six devices showing signs of compression in the long term. There was one fatality due to aneurysm rupture after 4 years.

Conclusions

The long-term efficiency of WEB deployment in larger, complex aneurysms is low with about half of the cases needing at least one retreatment. A large fraction of WEB collapse past 1-year follow-up.

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Abbreviations

IA:

Intracranial aneurysm

WEB:

Woven Endoluminal Bridge

WEB-DL:

WEB dual layer device

WEB-SL:

WEB single layer device

WEB-SLS:

WEB single layer spherical device

A1:

First segment of the anterior cerebral artery

PCoA:

Posterior communicating artery

CTA:

Computed tomography angiography

MRA:

Magnetic resonance angiography

MRI:

Magnetic resonance imaging

SD:

Standard deviation

ACoA:

Anterior communicating artery

MCA:

Middle cerebral artery

EVT:

Endovascular treatment

VA-dissection:

Vertebral artery dissection

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Authors and Affiliations

  1. Institute of Clinical Medicine, University in Oslo, Problemveien 17, 0315, Oslo, Norway

    Zaid Khalid & Angelika Sorteberg

  2. Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway

    Wilhelm Sorteberg & Angelika Sorteberg

  3. Department of Radiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway

    Bård Nedregaard

Authors
  1. Zaid Khalid
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  2. Wilhelm Sorteberg
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  3. Bård Nedregaard
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  4. Angelika Sorteberg
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Correspondence to Zaid Khalid.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

(The study has been approved by the institutional data protection officer as a quality study with reference number 2017/993)

Informed consent

Informed consent was waived by the data protection officer for this type of study.

Additional information

This article is part of the Topical Collection on Vascular Neurosurgery - Aneurysm

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Khalid, Z., Sorteberg, W., Nedregaard, B. et al. Efficiency and complications of Woven EndoBridge (WEB) devices for treatment of larger, complex intracranial aneurysms—a single-center experience. Acta Neurochir 161, 393–401 (2019). https://doi.org/10.1007/s00701-018-3752-0

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  • DOI: https://doi.org/10.1007/s00701-018-3752-0

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