Researchers have been using the Woven Endobridge (WEB) device to treat brain aneurysms for over 12 years, and their findings reveal how this innovative technique has evolved and improved patient outcomes. The WEB device works by disrupting blood flow into the aneurysm, allowing it to clot and heal. This study examines how the use of the WEB has shifted towards smaller aneurysms and broader applications, with the key being the strategy of oversizing the device to improve long-term results. The researchers also highlight the importance of careful patient selection and the potential for combining the WEB with other techniques like stenting for complex cases. This 12-year experience provides valuable insights into the evolving role of the WEB in the treatment of this serious neurological condition.
The Emergence of the Woven Endobridge
The Woven Endobridge (WEB) device has become a well-established technique for treating cerebral aneurysms over the past 12 years. These balloon-like bulges in the brain’s blood vessels can rupture, causing life-threatening subarachnoid hemorrhage.
The WEB works by disrupting the blood flow into the aneurysm, allowing it to clot and heal. This minimally invasive, endovascular approach has gained popularity as an alternative to traditional surgical clipping or coil embolization techniques.
Expanding Indications and Evolving Techniques
Over the 12-year study period, the researchers observed several key changes in how the WEB was used:
– Smaller Aneurysms: The average size of the treated aneurysms decreased from 7.7 mm to 5.0 mm, as the WEB 17 device allowed for the treatment of even smaller lesions.
– Broader Applications: The proportion of aneurysms treated in “atypical” locations, outside the original FDA-approved sites, increased from 5.9% to 38.1%.
– Oversizing Strategy: The researchers found that moderately oversizing the WEB device, making it slightly larger than the aneurysm dome, was a key factor in improving long-term angiographic outcomes and reducing the risk of neck remnants or aneurysm recurrence.
Balancing Safety and Efficacy
The study also examined the safety and efficacy of the WEB device:
– Procedural Complications: The overall procedural complication rate was 9.9%, with major neurological complications in 1.5% of cases and minor complications in 3.4%. Factors like ruptured aneurysm status and use of additional stents were associated with a higher risk of thromboembolic events.
– Angiographic Outcomes: At mid-term follow-up (6 months), the complete and adequate occlusion rates were 60.6% and 81.9%, respectively. Appropriate oversizing of the WEB was a key factor in achieving these favorable results.
– Retreatment Rates: The retreatment rate decreased from 13.7% in the first half of the study to 3.4% in the second half, as the researchers gained more experience and refined their techniques.
Expanding the Role of the WEB
The researchers conclude that the WEB has become an increasingly valuable tool in the treatment of cerebral aneurysms. By expanding the indications, optimizing the oversizing strategy, and carefully managing complications, the WEB has proven to be a safe and effective alternative to traditional treatment methods, especially for patients with saccular, WEB-suitable aneurysms.
Looking ahead, the researchers highlight the importance of long-term studies to further assess the safety and durability of the WEB approach. As the technology and clinical experience continue to evolve, the Woven Endobridge is poised to play an even more significant role in the management of this challenging neurological 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.
For More Related Articles Click Here
