Neurointervention.  2021 Nov;16(3):211-221. 10.5469/neuroint.2021.00395.

Ten Years of Clinical Evaluation of the Woven EndoBridge: A Safe and Effective Treatment for Wide-Neck Bifurcation Aneurysms

• Pierot L

• KMID: 2522035
• DOI: http://doi.org/10.5469/neuroint.2021.00395

Abstract

Intrasaccular flow disruption is an innovative approach for the endovascular treatment of intracranial aneurysms. As of now, only one device is currently available worldwide: the Woven EndoBridge (WEB) device (MicroVention, Aliso Viejo, CA, USA). After 10 years of clinical use and careful clinical evaluation of the WEB device by multiple prospective, multicenter studies, this article is summarizing the current knowledge regarding this endovascular technique; indications, modalities, safety and efficacy of the WEB procedure are described.

Keyword

Intracranial aneurysm; Endovascular technique; Device safety

Figure

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  Fig. 1. WEB devices (MicroVention, Aliso Viejo, CA, USA). (A) WEB SL. (B) WEB SLS. WEB, Woven EndoBridge; SL, single layer; SLS, single layer spherical.

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  Fig. 2. Selection of the WEB device (MicroVention, Aliso Viejo, CA, USA): ruptured anterior communicating artery aneurysm (informed consent for publication was not obtained so we anonymized the patient). (A) Non-contrast head CT showing bilateral subarachnoid hemorrhage. (B) 2D-DSA, front view, showing an anterior communicating artery aneurysm. (C) 2D-DSA, working view, showing the aneurysm. (D) 3D-DSA: measurements are performed to select the WEB device. Neck: 5.7 mm; width: 7.6 mm; height: 7.3 mm. (E) 3D-DSA, upper view of the dome. This view is very useful to measure the aneurysm width in 2 orthogonal directions: width 1: 9.0 mm; width 2: 7.0 mm. Mean width is 8 mm. (F) According to aneurysm measurements (D, E), A WEB SL 9x4 mm is selected. The device is oversized in width 1 mm and undersized in height 3 mm. (G) DSA, working view, after WEB detachment, showing complete aneurysm occlusion. (H) DSA, front view, after WEB detachment, showing complete aneurysm occlusion. (I) Flat-panel CT showing the WEB position in the aneurysm sac. (J) 1-year DSA showing complete aneurysm occlusion. WEB, Woven EndoBridge; CT, Computed Tomography; DSA, Digital Subtraction Angiography.

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