1. Endovascular treatment of intracranial aneurysms with the WEB device: A systematic review of clinical outcomes
- Author
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Francis Turjman, G Aulagner, Roberto Riva, Paul-Emile Labeyrie, Daniel Hartmann, Rotem Sivan-Hoffmann, Benjamin Gory, Xavier Armoiry, Matériaux, ingénierie et science [Villeurbanne] (MATEIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
medicine.medical_treatment ,morbidity ,woven endobridge dl ,030218 nuclear medicine & medical imaging ,[SPI.MAT]Engineering Sciences [physics]/Materials ,0302 clinical medicine ,systematic review ,device safety ,Occlusion ,Embolization ,Prospective cohort study ,Interventional ,Endovascular Procedures ,feasibility study ,cohort analysis ,Embolization, Therapeutic ,Thrombosis ,3. Good health ,Treatment Outcome ,Radiology ,Therapeutic ,devices ,Cohort study ,cardiovascular therapeutic device ,medicine.medical_specialty ,artificial embolization ,MEDLINE ,Article ,World Wide Web ,03 medical and health sciences ,Aneurysm ,medicine ,follow up ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,human ,Endovascular treatment ,outcome assessment ,woven endobridge sl ,business.industry ,Intracranial Aneurysm ,woven endobridge sls ,medicine.disease ,mortality ,Surgery ,Blood Vessel Prosthesis ,endovascular surgery ,adverse effects ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
cited By 13; International audience; BACKGROUND AND PURPOSE: Despite the improvement in technology, endovascular treatment of bifurcation intracranial wide-neck aneurysms remains challenging, mainly due to the difficulty of maintaining coils within the aneurysm sac without compromising the patency of bifurcation arteries. The Woven EndoBridge (WEB) device is a recent intrasaccular braided device specifically dedicated to treating such aneurysms with a wide neck by disrupting the flow in the aneurysmal neck and promoting progressive aneurysmal thrombosis. MATERIALS AND METHODS: Using several health data bases, we conducted a systematic review of all published studies of WEB endovascular treatment in intracranial aneurysms from 2010 onward to evaluate its efficacy and safety profile. RESULTS: The literature search identified 6 relevant studies (7 articles) including wide-neck bifurcation aneurysms in ≥80% of cases. Clinical data supporting the efficacy and safety of the WEB are limited to noncomparative cohort studies with large heterogeneity from a methodologic standpoint. The WEB deployment was feasible with a success rate of 93%-100%. Permanent morbidity (mRS of >1 at last follow-up) and mortality were measured at 2.2%- 6.7% and 0%-17%, respectively. The adequate occlusion rate (total occlusion or neck remnant) varied between 65% and 85.4% at midterm follow-up (range, 3.3-27.4 months). CONCLUSIONS: Endovascular treatment of bifurcation wide-neck aneurysms with the WEB device is feasible and allows an acceptably adequate aneurysm occlusion rate; however, the rate of neck remnants is not negligible. The WEB device needs further clinical and anatomic evaluation with long-term prospective studies, especially of the risk of WEB compression. Prospective controlled studies should be encouraged.
- Published
- 2016