Neurointervention.  2022 Mar;17(1):28-36. 10.5469/neuroint.2021.00430.

The Woven EndoBridge Device for the Treatment of Intracranial Aneurysms: Initial Clinical Experience within an Australian Population

Affiliations
  • 1Department of Radiology, Royal North Shore Hospital, Sydney, NSW, Australia
  • 2Department of Radiology, Interventional Neuroradiology Service, Austin Health, Melbourne, VIC, Australia
  • 3Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, VIC, Australia
  • 4School of Medicine, Deakin University, Waurn Ponds, VIC, Australia
  • 5Department of Radiology, Interventional Neuroradiology Service, St. Vincent’s Hospital, Melbourne, VIC, Australia
  • 6Department of Medical Imaging, Interventional Neuroradiology Service, The Canberra Hospital, ACT Health, Canberra, NSW, Australia
  • 7Department of Neurosurgery, Royal Hobart Hospital, Hobart, TAS, Australia
  • 8Department of Neurosurgery, Interventional Neuroradiology Service, Austin Health, Melbourne, VIC, Australia

Abstract

Purpose
Advances in endovascular technology have expanded the treatment options for intracranial aneurysms. Intrasaccular flow diversion is a relatively new technique that aims to disrupt blood inflow at the neck of the aneurysm, hence promoting intrasaccular thrombosis. The Woven EndoBridge device (WEB; MicroVention, Aliso Viejo, CA, USA) is an US Food and Drug Administration approved intrasaccular flow diverter for wide-necked aneurysms. We report the early interim clinical and radiological outcomes of patients with both ruptured and unruptured intracranial aneurysms (IAs) treated using the WEB device in an Australian population.
Materials and Methods
A retrospective analysis was done of patients with ruptured or unruptured IAs who received treatment with WEB across 5 Australian neuroendovascular referral centers between May 2017 and November 2020. Angiographic occlusion was assessed with time-of-flight magnetic resonance angiography. Complications were recorded and clinical outcomes were assessed using the modified Rankin scale at follow-up.
Results
In total, 66 aneurysms were treated in 63 patients, with successful deployment of the WEB device in 98.5% (n=65). Eighteen (26.9%) ruptured aneurysms were included. Failure of deployment occurred in a single case. Adjunct coiling and/or stenting was performed in 20.9% (n=14) cases. Sixty-two patients with 65 aneurysms using a WEB device were followed up (mean=9.1 months), and 89.4% of these had complete aneurysm occlusion while 1.5% remained patent. Functional independence was achieved in 93.5% of cases.
Conclusion
Early results following the use of WEB devices in Australia demonstrate safety and adequate aneurysm occlusion comparable to international literature.

Keyword

Intracranial aneurysm; Endovascular procedures; Woven EndoBridge device; WEB; Intrasaccular; Flow diversion

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