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Background <p>The woven EndoBridge (WEB) device has been introduced for the treatment of wide-neck bifurcation aneurysms; however, device selection remains a major challenge inWEB treatment. This study aimed to demonstrate the effectiveness of WEB selection using volumetric analysis and its 1-year radiological outcomes.</p> Methods <p>We retrospectively analysed patients with unruptured wide-neck bifurcation aneurysms who underwent WEB treatment between August 2021 and January 2023. Aneurysm volume was measured semi-automatically using a three-dimensional volume-rendering programme. Radiological outcomes were analysed using the WEB Occlusion Scale (WOS) at 1-year catheter angiography follow-up. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the prognostic performance of the device-to-aneurysm volume (DAV) ratio for predicting complete occlusion. Univariate and multivariate analyses were performed to assess the predictive factors for complete occlusion.</p> Results <p>Fifty-seven unruptured intracranial aneurysms, in 56 patients were treated with the WEB device. The device was changed in 14 patients (24.6%) following the + 1/-1 rule, and volume-based recommendations were appropriate for all patients. At the 1-year follow-up, complete occlusion (WOS A and B) was confirmed in 35 patients (61.4%), and adequate occlusion (WOS A, B, and C) was confirmed in 87.7% (50 of 57 patients). The ROC curve analysis showed a significant relationship for 1-year complete occlusion (area under the curve: 0.74, 95% confidence interval [CI]: 0.59–0.88) with an optimal cut-off of 0.92. The DAV ratio was the only significant predictive factor for 1-year complete occlusion in the univariate (odds ratio [OR]: 7.0, 95% CI: 2.20–24.7, <i>p</i> = 0.001) and multivariate (OR: 20.39, 95% CI: 3.56–111.73, <i>p</i> = 0.0007) analyses.</p> Conclusions <p>Volume-based WEB selection was appropriate for initial device selection and 1-year radiological outcomes. The selection of a WEB device with a volume exceeding 92% of that of the targeted aneurysm could be considered for 1-year radiological outcomes.</p>

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Optimal device-to-aneurysm ratio and one-year radiological outcomes of volume-based woven endobridge selection

  • 期刊论文

  • 发表日期：

    2025年12月11日

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  • Solbi Kim,
  • Kyu Seon Chung,
  • Jung-Jae Kim,
  • Keun Young Park,
  • Yong Bae Kim,
  • Hyun Jin Han

摘要

Background

The woven EndoBridge (WEB) device has been introduced for the treatment of wide-neck bifurcation aneurysms; however, device selection remains a major challenge inWEB treatment. This study aimed to demonstrate the effectiveness of WEB selection using volumetric analysis and its 1-year radiological outcomes.

Methods

We retrospectively analysed patients with unruptured wide-neck bifurcation aneurysms who underwent WEB treatment between August 2021 and January 2023. Aneurysm volume was measured semi-automatically using a three-dimensional volume-rendering programme. Radiological outcomes were analysed using the WEB Occlusion Scale (WOS) at 1-year catheter angiography follow-up. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the prognostic performance of the device-to-aneurysm volume (DAV) ratio for predicting complete occlusion. Univariate and multivariate analyses were performed to assess the predictive factors for complete occlusion.

Results

Fifty-seven unruptured intracranial aneurysms, in 56 patients were treated with the WEB device. The device was changed in 14 patients (24.6%) following the + 1/-1 rule, and volume-based recommendations were appropriate for all patients. At the 1-year follow-up, complete occlusion (WOS A and B) was confirmed in 35 patients (61.4%), and adequate occlusion (WOS A, B, and C) was confirmed in 87.7% (50 of 57 patients). The ROC curve analysis showed a significant relationship for 1-year complete occlusion (area under the curve: 0.74, 95% confidence interval [CI]: 0.59–0.88) with an optimal cut-off of 0.92. The DAV ratio was the only significant predictive factor for 1-year complete occlusion in the univariate (odds ratio [OR]: 7.0, 95% CI: 2.20–24.7, p = 0.001) and multivariate (OR: 20.39, 95% CI: 3.56–111.73, p = 0.0007) analyses.

Conclusions

Volume-based WEB selection was appropriate for initial device selection and 1-year radiological outcomes. The selection of a WEB device with a volume exceeding 92% of that of the targeted aneurysm could be considered for 1-year radiological outcomes.