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Purpose <p>The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for the treatment of wide-neck intracranial bifurcation aneurysms. The purpose of this study was to evaluate various factors associated with clinical and angiographic outcomes following WEB treatment.</p> Methods <p>This multicenter, retrospective study analyzed 405 patients with 412 aneurysms treated with the WEB device across 22 neurovascular centers. Clinical and radiologic data were reviewed to identify factors influencing patients’ clinical outcome and target aneurysmal occlusion at short-term (within 6 months) and long-term (beyond 1 year) follow-up. Occlusion status of target aneurysms was analyzed in relation to the various clinical and morphological factors. Outcomes were also compared based on institutional treatment volume.</p> Results <p>Centers with higher WEB treatment volumes (more than 30 cases) demonstrated lower thromboembolic events with sequelae (0.8% vs. 5.9%, <i>p</i> = 0.003). The rate of aneurysmal adequate occlusion, defined by Raymond-Roy occlusion class 1 and 2, increased from 70.2% at short-term (mean, 133 ± 42 days) to 83.2% at long-term (mean, 499 ± 134 days) follow-up (<i>p</i> = 0.003). Aneurysm diameter was inversely correlated with complete occlusion, with a 6-mm cutoff identified. Wide-neck aneurysms exhibited lower occlusion rates at short-term period, but this effect was not observed at later periods. Aneurysms at the basilar apex and internal carotid artery terminus demonstrated higher rates of complete occlusion (<i>p</i> = 0.046). Smoking acted as an inhibitor of long-term occlusion of target aneurysms.</p> Conclusion <p>Institutional experience appeared to play a role in reducing procedure-related thromboembolic complications. Aneurysmal diameter, neck width, location and patients’ smoking status influenced angiographic outcomes.</p>

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Predictors of clinical and angiographic outcomes after woven EndoBridge treatment for intracranial aneurysms: an asian multicenter cohort study

  • 期刊论文

  • 发表日期：

    2025年12月2日

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  • Je Hun Jang,
  • Kangmin Kim,
  • Keunyoung Park,
  • Yong Sam Shin,
  • Dae-Won Kim,
  • Jung Hyun Park,
  • Hae Woong Jeong,
  • Seung Pil Ban,
  • Hyun-Seung Kang,
  • Seung Pil Ban,
  • Dong Young Cho,
  • Woo Cheul Cho,
  • Yeongu Chung,
  • Hyunjin Han,
  • Chang Ki Jang,
  • Dong-Kyu Jang,
  • Je Hun Jang,
  • Donghwan Jeong,
  • Hae Woong Jeong,
  • Sung-Chul Jin,
  • Hyunjun Jo,
  • Hyun-Seung Kang,
  • Byungmoon Kim,
  • Chang Hyeun Kim,
  • Dae-Won Kim,
  • Hyun Sik Kim,
  • Jungjae Kim,
  • Junki Kim,
  • Kangmin Kim,
  • Myeong Jin Kim,
  • Tae Gon Kim,
  • Soon Chan Kwon,
  • Jong Young Lee,
  • Jung Hyun Park,
  • Keunyoung Park,
  • Sukh Que Park,
  • Yong Sam Shin,
  • Won-ki Yoon

摘要

Purpose

The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for the treatment of wide-neck intracranial bifurcation aneurysms. The purpose of this study was to evaluate various factors associated with clinical and angiographic outcomes following WEB treatment.

Methods

This multicenter, retrospective study analyzed 405 patients with 412 aneurysms treated with the WEB device across 22 neurovascular centers. Clinical and radiologic data were reviewed to identify factors influencing patients’ clinical outcome and target aneurysmal occlusion at short-term (within 6 months) and long-term (beyond 1 year) follow-up. Occlusion status of target aneurysms was analyzed in relation to the various clinical and morphological factors. Outcomes were also compared based on institutional treatment volume.

Results

Centers with higher WEB treatment volumes (more than 30 cases) demonstrated lower thromboembolic events with sequelae (0.8% vs. 5.9%, p = 0.003). The rate of aneurysmal adequate occlusion, defined by Raymond-Roy occlusion class 1 and 2, increased from 70.2% at short-term (mean, 133 ± 42 days) to 83.2% at long-term (mean, 499 ± 134 days) follow-up (p = 0.003). Aneurysm diameter was inversely correlated with complete occlusion, with a 6-mm cutoff identified. Wide-neck aneurysms exhibited lower occlusion rates at short-term period, but this effect was not observed at later periods. Aneurysms at the basilar apex and internal carotid artery terminus demonstrated higher rates of complete occlusion (p = 0.046). Smoking acted as an inhibitor of long-term occlusion of target aneurysms.

Conclusion

Institutional experience appeared to play a role in reducing procedure-related thromboembolic complications. Aneurysmal diameter, neck width, location and patients’ smoking status influenced angiographic outcomes.