Abstract
The Woven EndoBridge (WEB) device has been widely used to treat intracranial wide neck bifurcation aneurysms. Initial studies have demonstrated that approximately 90% of patients have same or improved long-term aneurysm occlusion after the initial 6-month follow up. The aim of this study is to assess the long-term follow-up in aneurysms that have achieved complete occlusion at 6 months. We also compared the predictive value of different imaging modalities used. This is an analysis of a prospectively maintained database across 13 academic institutions. We included patients with previously untreated cerebral aneurysms embolized using the WEB device who achieved complete occlusion at first follow-up and had available long-term follow-up. A total of 95 patients with a mean age of 61.6 ± 11.9 years were studied. The mean neck diameter and height were 3.9 ± 1.3 mm and 6.0 ± 1.8 mm, respectively. The mean time to first and last follow-up was 5.4 ± 1.8 and 14.1 ± 12.9 months, respectively. Out of all the aneurysms that were completely occluded at 6 months, 84 (90.3%) showed complete occlusion at the final follow-up, and 11(11.5%) patients did not achieve complete occlusion. The positive predictive value (PPV) of complete occlusion at first follow was 88.4%. Importantly, this did not differ between digital subtraction angiography (DSA), magnetic resonance angiography (MRA), or computed tomography angiography (CTA). This study underlines the importance of repeat imaging in patients treated with the WEB device even if complete occlusion is achieved short term. Follow-up can be performed using DSA, MRA or CTA with no difference in positive predictive value.
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Conceptualization: KEN, PM, AD. Methodology: KEN, PM, AD, NA. Formal analysis: PM. Data curation: all authors. Original draft preparation: KEN. Prepared figure: KEN. Visualization: all authors. Study supervision: AD. Reviewing and editing: all authors.
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Dr. Jabbour is a consultant for Medtronic, MicroVention, Balt, and Cerus Endovascular. Dr. Tjoumakaris is a consultant for Medtronic and MicroVention. Dr. Gooch is a consultant for Stryker. Dr. Regenhardt is DSMB member for Rapid Medical, site PI for MicroVention, and site PI for Penumbra. The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
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El Naamani, K., Mastorakos, P., Adeeb, N. et al. Long-Term Follow-Up of Cerebral Aneurysms Completely Occluded at 6 Months After Intervention with the Woven EndoBridge (WEB) Device: a Retrospective Multicenter Observational Study. Transl. Stroke Res. (2023). https://doi.org/10.1007/s12975-023-01153-5
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DOI: https://doi.org/10.1007/s12975-023-01153-5