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Treatment of Ruptured and Unruptured Intracranial Aneurysms with WEB 17 Versus WEB 21 Systems

Comparison of Indications and Early Angiographic Outcomes

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Abstract

Background

The concept of intrasaccular flow diversion using the Woven EndoBridge (WEB) device changed the traditional endovascular concept for wide-necked bifurcation aneurysms. The latest technical advancement resulted in the WEB 17 system, a softer device composed of fewer wires which enables treatment of smaller more distally located aneurysms by using smaller microcatheters as compared to the WEB 21 system.

Objective

This retrospective observational study aimed to evaluate and compare the angiographic and clinical results achieved with WEB 21 and WEB 17 in aneurysm morphologies eligible for both systems (maximum width 3–6 mm).

Methods

Between August 2014 and August 2019 a total of 63 and 130 aneurysms with a maximum width of 3–6 mm were treated with either WEB 21 and WEB 17, respectively, at 2 neurovascular centers. Cases were analyzed based on a comparison regarding aneurysm size, location and rupture status.

Results

The technical success, the periprocedural complication rate and the rate of additional devices used showed no relevant differences between the two groups. Aneurysms treated with the WEB 17 system were smaller and more frequently distally located. The overall complete occlusion rate at 3 months was higher in the WEB 17 group (65.5% versus 55.1%). The superiority of complete aneurysm occlusion achieved with WEB 17 was statistically significant in the subgroup of unruptured middle cerebral artery aneurysms.

Conclusion

The use of WEB 17 expands the treatment indications for intrasaccular flow-diversion towards smaller and more distally located aneurysms with a safety profile comparable with that of the WEB 21.

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Abbreviations

ACA A2:

Anterior cerebral artery A2-segment

AcomA:

Anterior communicating artery

SCA:

Superior cerebellar artery

CT:

Computed tomography

F:

French

GCP:

Good clinical practice

ICA:

Internal carotid artery

MCA bif:

Middle cerebral artery bifurcation

MCA M1:

Middle cerebral artery M1-segment

mRS:

Modified Rankin scale

PCA P2:

posterior cerebral artery P2-segment

Pcom:

Posterior communicating artery

PICA:

Posterior inferior cerebellar artery

SAH:

Subarachnoid hemorrhage

WEB:

Woven EndoBridge

References

  1. Arthur AS, Molyneux A, Coon AL, Saatci I, Szikora I, Baltacioglu F, Sultan A, Hoit D, Delgado Almandoz JE, Elijovich L, Cekirge S, Byrne JV, Fiorella D; WEB-IT Study investigators. The safety and effectiveness of the Woven EndoBridge (WEB) system for the treatment of wide-necked bifurcation aneurysms: final 12-month results of the pivotal WEB Intrasaccular Therapy (WEB-IT) Study. J Neurointerv Surg. 2019;11:924–30.

    Article  Google Scholar 

  2. Pierot L, Spelle L, Molyneux A, Byrne J; WEBCAST and French Observatory Investigators. Clinical and Anatomical Follow-up in Patients With Aneurysms Treated With the WEB Device: 1-Year Follow-up Report in the Cumulated Population of 2 Prospective, Multicenter Series (WEBCAST and French Observatory). Neurosurgery. 2016;78:133–41.

    Article  Google Scholar 

  3. Pierot L, Costalat V, Moret J, Szikora I, Klisch J, Herbreteau D, Holtmannspötter M, Weber W, Januel AC, Liebig T, Sychra V, Strasilla C, Cognard C, Bonafé A, Molyneux A, Byrne JV, Spelle L. Safety and efficacy of aneurysm treatment with WEB: results of the WEBCAST study. J Neurosurg. 2016;124:1250–6.

    Article  Google Scholar 

  4. Caroff J, Mihalea C, Klisch J, Strasilla C, Berlis A, Patankar T, Weber W, Behme D, Jacobsen EA, Liebig T, Prothmann S, Cognard C, Finkenzeller T, Moret J, Spelle L. Single-Layer WEBs: Intrasaccular Flow Disrupters for Aneurysm Treatment—Feasibility Results from a European Study. AJNR Am J Neuroradiol. 2015;36:1942–6.

    Article  CAS  Google Scholar 

  5. Ding YH, Lewis DA, Kadinvel R, Dai D, Kallmes DF. The Woven EndoBridge: a new aneurysm occlusion device. AJNR Am J Neuroradiol. 2011;32:607–11.

    Article  CAS  Google Scholar 

  6. Popielski J, Berlis A, Weber W, Fischer S. Two-center experience in the endovascular treatment of ruptured and unruptured intracranial aneurysms using the WEB Device: a retrospective analysis. AJNR Am J Neuroradiol. 2018;39:111–7.

    Article  CAS  Google Scholar 

  7. Maurer C, König I, Berlis A, Weber W, Fischer S. Two-Center Experience in the Endovascular Treatment of Intracranial Aneurysms Using the Woven EndoBridge 17 Device Including Midterm Follow-Up Results: A Retrospective Analysis. AJNR Am J Neuroradiol. 2019;40:1517–22.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Van Rooij SBT, Peluso JP, Sluzewski M, Kortman HG, van Rooij WJ. The new low-profile WEB 17 system for treatment of intracranial aneurysms: first clinical experience. AJNR Am J Neuroradiol. 2018;39:859–63.

    Article  CAS  Google Scholar 

  9. Lescher S, du Mesnil de Rochemont R, Berkefeld J. Woven Endobridge (WEB) device for endovascular treatment of complex unruptured aneurysms—a single center experience. Neuroradiology. 2016;58:383–90.

    Article  Google Scholar 

  10. Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke. 2001;32:1998–2004.

    Article  CAS  Google Scholar 

  11. Pierot L, Gubucz I, Buhk JH, Holtmannspötter M, Herbreteau D, Stockx L, Spelle L, Berkefeld J, Januel AC, Molyneux A, Byrne JV, Fiehler J, Szikora I, Barreau X. Safety and Efficacy of Aneurysm Treatment with the WEB: Results of the WEBCAST 2 Study. AJNR Am J Neuroradiol. 2017;38:1151–5.

    Article  CAS  Google Scholar 

  12. Pierot L, Moret J, Barreau X, Szikora I, Herbreteau D, Turjman F, Holtmannspötter M, Januel AC, Costalat V, Fiehler J, Klisch J, Gauvrit JY, Weber W, Desal H, Velasco S, Liebig T, Stockx L, Berkefeld J, Molyneux A, Byrne J, Spelle L. Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series. J Neurointerv Surg. 2018;10:553–9.

    Article  Google Scholar 

  13. Mihalea C, Caroff J, Pagiola I, Ikka L, Hashemi GB, Naderi S, Chalumeau V, Ples H, Popa BV, Yasuda T, Marenco de la Torre JJ, Iacobucci M, Ozanne A, Gallas S, Rouchaud A, Pescariu S, Moret J, Spelle L. Safety and efficiency of the fifth generation Woven EndoBridge device: technical note. J Neurointerv Surg. 2019;11:511–5.

    Article  Google Scholar 

  14. CLEVER CLinical EValuation of WEB 0.017 Device in Intracranial Aneurysms. 2019. https://www.clinicaltrials.gov. Accessed 15 May 2020.

  15. Goertz L, Liebig T, Siebert E, Herzberg M, Pennig L, Schlamann M, Borggrefe J, Krischek B, Dorn F, Kabbasch C. Low-Profile Intra-Aneurysmal Flow Disruptor WEB 17 versus WEB Predecessor Systems for Treatment of Small Intracranial Aneurysms: Comparative Analysis of Procedural Safety and Feasibility. AJNR Am J Neuroradiol. 2019;40:1766–72.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Goertz L, Liebig T, Siebert E, Herzberg M, Neuschmelting H, Borggrefe J, Onur ÖA, Dorn F, Kabbasch C. Risk Factors of Procedural Complications Related to Woven EndoBridge (WEB) Embolization of Intracranial Aneurysms. Clin Neuroradiol. 2020;30:297–304.

    Article  Google Scholar 

  17. Lawson A, Molyneux A, Sellar R, Lamin S, Thomas A, Gholkar A, Patankar T. Safety results from the treatment of 109 cerebral aneurysms using the Woven EndoBridge technique: preliminary results in the United Kingdom. J Neurosurg. 2018;128:144–53.

    Article  Google Scholar 

  18. Fiorella D, Molyneux A, Coon A, Szikora I, Saatci I, Baltacioglu F, Sultan A, Arthur A; WEB-IT Study Investigators. Demographic, procedural and 30-day safety results from the WEB Intra-saccular Therapy Study (WEB-IT). J Neurointerv Surg. 2017;9:1191–6.

    Article  Google Scholar 

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. For the 10 cases included in the CLEVER study funding was received according to the study protocol and money was paid to the institution.

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Authors and Affiliations

  1. Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum-Langendreer, In der Schornau 23–25, 44892, Bochum, Germany

    I. König, V. Maus, W. Weber & S. Fischer

  2. Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany

    C. Maurer & A. Berlis

Authors
  1. I. König
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  2. C. Maurer
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  3. A. Berlis
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  4. V. Maus
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  5. W. Weber
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  6. S. Fischer
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Contributions

I. König: project development, data collection, manuscript preparation, C. Maurer: project development, data collection, A. Berlis: data collection, critical review of the manuscript, V. Maus: critical review of the manuscript, W. Weber: critical review of the manuscript, S. Fischer: project development, data collection and analysis, manuscript preparation and writing

Corresponding author

Correspondence to S. Fischer.

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Conflict of interest

C. Maurer: agreement with Microvention Inc./Sequent Medical for consulting. A. Berlis: agreement with Microvention Inc./Sequent Medical for proctoring services and consulting. W. Weber: agreement with Microvention Inc./Sequent Medical for proctoring services and consulting. S. Fischer: agreement with Microvention Inc./Sequent Medical for proctoring services and consulting. I. König and V. Maus declare that they have no competing interests.

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König, I., Maurer, C., Berlis, A. et al. Treatment of Ruptured and Unruptured Intracranial Aneurysms with WEB 17 Versus WEB 21 Systems. Clin Neuroradiol 31, 691–697 (2021). https://doi.org/10.1007/s00062-020-00946-7

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  • DOI: https://doi.org/10.1007/s00062-020-00946-7

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