Researchers have been using a cutting-edge medical device called the Woven Endobridge (WEB) to treat brain aneurysms for over a decade. In this comprehensive study, scientists from multiple medical centers analyzed data from 324 aneurysm cases treated with the WEB between 2011 and 2023. The findings reveal how the use of the WEB has evolved, with smaller aneurysms and broader indications being treated over time. The study also highlights the importance of properly “oversizing” the WEB device to improve long-term outcomes. This research provides valuable insights into the effective use of the WEB and the continued advancement of endovascular techniques for managing this serious medical condition.
Expanding the Frontiers of Brain Aneurysm Treatment
Brain aneurysms are a serious medical condition where a weak spot in the wall of a blood vessel in the brain balloons out, creating a risk of rupture and life-threatening subarachnoid hemorrhage. Over the past decade, the Woven Endobridge (WEB) device has emerged as a promising endovascular treatment option for these challenging cases.
Charting the Evolution of WEB Usage
In this comprehensive study, researchers from three leading medical centers analyzed data from 324 brain aneurysm cases treated with the WEB between 2011 and 2023. The findings reveal a remarkable evolution in the use of this innovative device.
Shifting Towards Smaller Aneurysms
Over the 12-year study period, the researchers observed a significant decrease in the average size of the treated aneurysms, from 7.7 mm to just 5.0 mm. This shift towards smaller aneurysms was accompanied by an expansion of the WEB’s indications beyond the initial FDA-approved locations, with the proportion of “atypical” treatment sites increasing from 5.9% to 38.1%.
Optimizing the Oversizing Strategy
One of the key factors contributing to the success of WEB treatment was the researchers’ emphasis on “oversizing” the device. By ensuring the WEB was slightly larger than the aneurysm’s dome diameter, the team was able to achieve better sealing of the aneurysm neck and improved long-term outcomes. Multivariate analysis showed that this oversizing strategy was an independent predictor of adequate aneurysm occlusion.
Balancing Safety and Efficacy
The study also shed light on the safety and efficacy of WEB treatment. The overall procedural complication rate was 9.9%, with major neurological complications occurring in just 1.5% of cases. Importantly, the researchers observed a decrease in the rate of thromboembolic events over the study period, potentially attributable to the introduction of the lower-profile WEB 17 system.
In terms of angiographic outcomes, the researchers reported a mid-term complete occlusion rate of 60.6% and an adequate occlusion rate of 81.9%. While some aneurysm recurrences were observed during long-term follow-up, the overall retreatment rate remained low at 7.1% at mid-term and 1.6% at long-term.
Unlocking the Potential of the WEB
This comprehensive study provides valuable insights into the evolving use of the WEB device for the treatment of brain aneurysms. The findings highlight the importance of proper device sizing, the potential for expanding indications beyond traditional locations, and the continued improvement in safety and efficacy.
As the researchers note, “the simplicity of WEB deployment, the safety and efficacy profile, and the lack of need for antiplatelet therapy have made WEB the preferred treatment option” for many unruptured aneurysms. With ongoing advancements in the device and delivery systems, the WEB is poised to play an increasingly significant role in the management of this challenging medical condition.
Author credit: This article is based on research by Lukas Goertz, Thomas Liebig, Eberhard Siebert, David Zopfs, Lenhard Pennig, Muriel Pflaeging, Marc Schlamann, Alexandra Radomi, Franziska Dorn, Christoph Kabbasch.
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