Intrasaccular Flow Disruption with the Woven EndoBridge for Narrow-Necked Aneurysms: A Safety and Feasibility Study

World Neurosurg. 2021 Jul:151:e278-e285. doi: 10.1016/j.wneu.2021.04.018. Epub 2021 Apr 15.

Abstract

Objective: The Woven EndoBridge (WEB) received U.S. Food and Drug Administration approval for endovascular treatment of wide-necked bifurcation aneurysms. We evaluated the feasibility, safety, and efficacy of the WEB for treatment of narrow-necked aneurysms.

Methods: This multicenter study included 17 narrow-necked aneurysms, defined by a neck width <4 mm and a dome-to-neck ratio >2. Aneurysm characteristics, treatment strategies, technical success, complications, and angiographic outcomes were retrospectively assessed.

Results: Aneurysm locations included the internal carotid artery (7 cases), anterior communicating artery (4 cases), middle cerebral artery (4 cases), and basilar artery (2 cases). The median aneurysm size was 7.4 mm with a median neck width of 2.3 mm. The technical success rate was 100%. There were no neurological complications. Angiographic control revealed complete and adequate occlusion in 13 of 15 (86.7%) and 14 of 15 (93.3%) cases, respectively, after 6 months and in 6 of 7 (85.6%) and 7 of 7 (100%) cases, respectively, after a median of 13 months. Two aneurysms were retreated with flow diverters.

Conclusions: WEB embolization of narrow-necked aneurysms was technically feasible and safe and might be considered as an alternative treatment option to conventional coiling in selected cases.

Keywords: Aneurysm occlusion; Endovascular; Feasibility; Intracranial aneurysm; Wide-necked.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Embolization, Therapeutic / methods*
  • Endovascular Procedures / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Stents*
  • Treatment Outcome