Safety and efficacy of the Woven Endo-Bridge-17 device for intracranial aneurysm treatment: A systematic review and meta-analysis

Sherief Ghozy; Ahmed Sallam Motawei; Charbel Moussalem; Amro Elrefaei; Hassan Kobeissi; Alzhraa S Abbas; Adam A Dmytriw; David F Kallmes; Ramanathan Kadirvel

doi:10.1177/15910199231226294

Safety and efficacy of the Woven Endo-Bridge-17 device for intracranial aneurysm treatment: A systematic review and meta-analysis

Interv Neuroradiol. 2024 Jan 17:15910199231226294. doi: 10.1177/15910199231226294. Online ahead of print.

Authors

Affiliations

¹ Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
² Department of Radiology, Mayo Clinic, Rochester, MN, USA.
³ Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
⁴ Evidence-based Practice Center, Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA.
⁵ Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
⁶ Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St Michael's Hospital, Toronto, ON, Canada.

PMID: 38234203
DOI: 10.1177/15910199231226294

Abstract

Background: The Woven Endo-Bridge (WEB) device revolutionized the treatment of wide-necked bifurcation aneurysms by intrasaccular flow diversion. The latest advancement is the WEB-17 system, offering greater flexibility with fewer wires, enabling treatment of smaller distal aneurysms using smaller microcatheters than the WEB-21 system.

Methods: We conducted a systematic review following preferred reporting items for systematic reviews and meta-analyses guidelines, analyzing data from seven retrospective cohort studies involving 483 aneurysms treated with the WEB-17 device. Statistical analysis computed pooled prevalence rates and 95% confidence intervals using appropriate models for each outcome and R software version 4.3.1 (R Foundation for Statistical Computing, Vienna, Austria).

Results: Technical success was achieved in 475 out of 483 aneurysms treated with the WEB-17 device, with a success rate of 98.34% (95% confidence interval (CI) = 96.72-99.17). Among the successful cases, 4.97% (95% CI = 1.60-14.39) required adjunctive devices. Adequate occlusion, defined as complete occlusion or neck remnants, was observed in 94.41% (95% CI = 88.17-97.46) of cases. Periprocedural complications were infrequent, with thromboembolic complications occurring in 4.93% (95% CI = 3.29-7.30) of cases, hemorrhagic complications in 1.28% (95% CI = 0.58-2.83), and postprocedural neurologic complications in 0.99% (95% CI = 0.31-3.14). Procedure-related morbidity was observed in 1.71% (95% CI = 0.86-3.39) of cases, and there was one procedure-related mortality reported at 0.21% (95% CI = .03-1.50). Mortality unrelated to the procedure occurred in 1% (95% CI = 0.23-4.15).

Conclusion: Our findings suggest that the WEB-17 device is associated with a high rate of technical success, favorable angiographic outcomes, and a low rate of periprocedural complications. Further research, including prospective trials, is needed to confirm these findings and establish its safety and efficacy definitively.

Keywords: Endovascular intervention; WEB-17 device; intracranial aneurysms; meta-analysis; wide-neck bifurcation.

Publication types

Review