The Woven EndoBridge device as a good alternative treatment for stent assisted coiling in intracranial bifurcation aneurysms: a systematic review and meta-analysis.

Objectives: The Woven EndoBridge (WEB), functioning as an intrasaccular disruption device, offers a novel option for complex aneurysms, particularly bifurcation aneurysms. In this systematic review and meta-analysis, our goal is to compare the safety and efficacy of WEB devices with stent-assisted coiling (SAC) for intracranial bifurcation aneurysms. Methods: We conducted a systematic search of PubMed, Scopus, and Embase, and Web of Science databases in September 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We aimed to compare aneurysmal occlusion, procedural time, the retreatment, and complication rates as secondary objectives. The comparison between the two techniques was performed using a weighted random-effects model, and the quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies. Results: The authors analyzed five studies encompassing 298 and 203 patients in SAC and WEB groups, respectively. Complete (OR, 0.97; 95%CI: 0.63–1.49, I2 = 0%) and adequate (OR: 0.88; 95%CI: 0.51–1.5, I2 = 0%) occlusion didn't differ between two groups. The overall procedural time mean difference was 38.2 min, significantly higher in the SAC group (95%CI, 26.9–49.6, I2 = 53.4%). Retreatment rates did not significantly differ between the two groups (OR: 1.34; 95%CI: 0.37–4.85, I2 = 61.7%). The SAC group experienced more complications during and after the operation (OR, 2.82; 95%CI: 1.07–7.44, I2 = 0%). The pooled follow-up duration was 22.1 and 13.5 months for SAC and WEB groups respectively. Conclusion: The WEB demonstrates comparable efficacy in occluding bifurcation aneurysms compared to SAC, with the added benefits of reduced procedural time and lower complication rates. [ABSTRACT FROM AUTHOR]