Abstract
Background
The Woven EndoBridge (WEB) devices have been used for treating wide neck bifurcation aneurysms (WNBAs) with several generational enhancements to improve clinical outcomes. The original device dual-layer (WEB DL) was replaced by a single-layer (WEB SL) device in 2013. This study aimed to compare the effectiveness and safety of these devices in managing intracranial aneurysms.
Methods
A multicenter cohort study was conducted, and data from 1,289 patients with intracranial aneurysms treated with either the WEB SL or WEB DL devices were retrospectively analyzed. Propensity score matching was utilized to balance the baseline characteristics between the two groups. Outcomes assessed included immediate occlusion rate, complete occlusion at last follow-up, retreatment rate, device compaction, and aneurysmal rupture.
Results
Before propensity score matching, patients treated with the WEB SL had a significantly higher rate of complete occlusion at the last follow-up and a lower rate of retreatment. After matching, there was no significant difference in immediate occlusion rate, retreatment rate, or device compaction between the WEB SL and DL groups. However, the SL group maintained a higher rate of complete occlusion at the final follow-up. Regression analysis showed that SL was associated with higher rates of complete occlusion (OR: 0.19; CI: 0.04 to 0.8, p = 0.029) and lower rates of retreatment (OR: 0.12; CI: 0 to 4.12, p = 0.23).
Conclusion
The WEB SL and DL devices demonstrated similar performances in immediate occlusion rates and retreatment requirements for intracranial aneurysms. The SL device showed a higher rate of complete occlusion at the final follow-up.
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A.A.D., H.S., B.M., A.A., N.M.C., R.M.M., O.A., S.G., M.D., S.V.L., A.G., L.R., J.C., G.S., P.M., K.E.N., E.S., K.P., M.M., M.K., O.D., C.C., M.M.S., I.L., P.M.F., J.A.V., H.S., V.Ž., M.U.H., J.C., M.W., V.M.T., M.K.I., M.A.M., C.I., A.B., J.D.R., Y.R., C.M.S., M.P., A.L.K., C.M., S.E., R.M.S., A.H., M.O., P.S., J.J., W.B., M.T.N., M.P., C.U., J.D.B.D., B.P., J.K.B., T.H., J.C.M.G., M.A.E., S.A.S., G.S., R.T., B.L., P.P., A.S.P., G.P., E.N., E.R., M.K.O., C.J.G., H.A., A.S., A.L.B., D.A., A.F.D., F.C.A., R.W.R., C.J.S., P.K., V.K., P.L., S.B., J.K., M.A.A.S., S.I.T., F.C., N.L., H.H.C.S., A.J., V.M.P., A.B.P., N.A., M.A.M., C.I., A.B., J.D.R., Y.R., C.M.S., M.P., A.L.K., C.M., S.E., R.M.S., A.H., M.O., P.S., J.J., W.B., M.T.N., M.P., C.U., J.D.B.D., B.P., J.K.B., T.H., J.C.M.G., M.A.E., S.A.S., G.S., R.T., B.L., P.P., A.S.P., G.P., E.N., E.R., M.K.O., C.J.G., H.A., A.S., A.L.B., D.A., A.F.D., F.C.A., R.W.R., C.J.S., P.K., V.K., P.L., S.B., J.K., M.A.A.S., S.I.T., F.C., N.L., H.H.C.S., M.J.P., A.B.P., N.A., M.A.E., S.B., G.S., R.T., B.L., P.P., A.S.P., G.P., E.N., E.R., M.K.O., C.J.G., H.A., A.S., A.L.B., D.A., A.F.D., F.C.A., R.W.R., C.J.S., P.K., V.K., P.L., S.B., J.K., M.A.A.S., S.I.T., F.C., N.L., H.H.C.S., M.J.P., A.B.P., N.A. contributed to the conception and design of the work.
A.A.D., H.S., B.M., A.A., N.M.C., R.M.M., O.A., S.G., M.D., S.V.L., A.G., L.R., J.C., G.S., P.M., K.E.N., E.S., K.P., M.M., M.K., O.D., C.C., M.M.S., I.L., P.M.F., J.A.V., H.S., V.Ž., M.U.H., J.C., M.W., V.M.T., M.K.I., M.A.M., C.I., A.B., J.D.R., Y.R., C.M.S., M.P., A.L.K., C.M., S.E., R.M.S., A.H., M.O., P.S., J.J., W.B., M.T.N., M.P., C.U., J.D.B.D., B.P., J.K.B., T.H., J.C.M.G., M.A.E., S.A.S., G.S., R.T., B.L., P.P., A.S.P., G.P., E.N., E.R., M.K.O., C.J.G., H.A., A.S., A.L.B., D.A., A.F.D., F.C.A., R.W.R., C.J.S., P.K., V.K., P.L., S.B., J.K., M.A.A.S., S.I.T., F.C., N.L., H.H.C.S., A.J., V.M.P., A.B.P., N.A., M.A.M., C.I., A.B., J.D.R., Y.R., C.M.S., M.P., A.L.K., C.M., S.E., R.M.S., A.H., M.O., P.S., J.J., W.B., M.T.N., M.P., C.U., J.D.B.D., B.P., J.K.B., T.H., J.C.M.G., M.A.E., S.A.S., G.S., R.T., B.L., P.P., A.S.P., G.P., E.N., E.R., M.K.O., C.J.G., H.A., A.S., A.L.B., D.A., A.F.D., F.C.A., R.W.R., C.J.S., P.K., V.K., P.L., S.B., J.K., M.A.A.S., S.I.T., F.C., N.L., H.H.C.S., M.J.P., A.B.P., N.A., M.A.E., S.B., G.S., R.T., B.L., P.P., A.S.P., G.P., E.N., E.R., M.K.O., C.J.G., H.A., A.S., A.L.B., D.A., A.F.D., F.C.A., R.W.R., C.J.S., P.K., V.K., P.L., S.B., J.K., M.A.A.S., S.I.T., F.C., N.L., H.H.C.S., M.J.P., A.B.P., N.A. were involved in the acquisition of data, and data analysis and interpretation.
A.A.D., H.S., B.M., A.A., N.M.C., R.M.M., O.A., S.G., M.D., S.V.L., A.G., L.R., J.C., G.S., P.M., K.E.N., E.S., K.P., M.M., M.K., O.D., C.C., M.M.S., I.L., P.M.F., J.A.V., H.S., V.Ž., M.U.H., J.C., M.W., V.M.T., M.K.I., M.A.M., C.I., A.B., J.D.R., Y.R., C.M.S., M.P., A.L.K., C.M., S.E., R.M.S., A.H., M.O., P.S., J.J., W.B., M.T.N., M.P., C.U., J.D.B.D., B.P., J.K.B., T.H., J.C.M.G., M.A.E., S.A.S., G.S., R.T., B.L., P.P., A.S.P., G.P., E.N., E.R., M.K.O., C.J.G., H.A., A.S., A.L.B., D.A., A.F.D., F.C.A., R.W.R., C.J.S., P.K., V.K., P.L., S.B., J.K., M.A.A.S., S.I.T., F.C., N.L., H.H.C.S., A.J., V.M.P., A.B.P., N.A., M.A.M., C.I., A.B., J.D.R., Y.R., C.M.S., M.P., A.L.K., C.M., S.E., R.M.S., A.H., M.O., P.S., J.J., W.B., M.T.N., M.P., C.U., J.D.B.D., B.P., J.K.B., T.H., J.C.M.G., M.A.E., S.A.S., G.S., R.T., B.L., P.P., A.S.P., G.P., E.N., E.R., M.K.O., C.J.G., H.A., A.S., A.L.B., D.A., A.F.D., F.C.A., R.W.R., C.J.S., P.K., V.K., P.L., S.B., J.K., M.A.A.S., S.I.T., F.C., N.L., H.H.C.S., M.J.P., A.B.P., N.A., M.A.E., S.B., G.S., R.T., B.L., P.P., A.S.P., G.P., E.N., E.R., M.K.O., C.J.G., H.A., A.S., A.L.B., D.A., A.F.D., F.C.A., R.W.R., C.J.S., P.K., V.K., P.L., S.B., J.K., M.A.A.S., S.I.T., F.C., N.L., H.H.C.S., M.J.P., A.B.P., N.A. drafted the work and revised it critically for important intellectual content.
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Adam A. Dmytriw, Hamza Salim and Basel Musmar are co-first authors.
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Dmytriw, A.A., Salim, H., Musmar, B. et al. Dual Layer vs Single Layer Woven EndoBridge Device in the Treatment of Intracranial Aneurysms: A Propensity Score-Matched Analysis. Neurosurg Rev 47, 116 (2024). https://doi.org/10.1007/s10143-024-02341-z
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DOI: https://doi.org/10.1007/s10143-024-02341-z