CLinical EValuation of WEB 17 device in intracranial aneuRysms (CLEVER): 1-year effectiveness results for ruptured and unruptured aneurysms

被引:1
作者
Spelle, Laurent [1 ,2 ]
Costalat, Vincent [3 ]
Caroff, Jildaz [1 ,2 ]
Wodarg, Fritz [4 ]
Fischer, Sebastian [5 ]
Herbreteau, Denis [6 ]
Moehlenbruch, Markus A. [7 ]
Januel, Anne-Christine [8 ]
Papagiannaki, Chrysanthi [9 ]
Klisch, Joachim [10 ]
Numminen, Jussi [11 ]
Rautio, Riitta [12 ]
Berlis, Ansgar [13 ]
Mihalea, Cristian [1 ]
Chalumeau, Vanessa [1 ]
Downer, Jonathan [14 ,15 ]
Cortese, Jonathan [1 ,2 ]
Ikka, Leon [1 ]
Gallas, Sophie [1 ]
Bester, Maxim [16 ]
Liebig, Thomas [17 ]
Velasco, Stephane [18 ]
Grimaldi, Lamiae [2 ,19 ]
Byrne, James [20 ]
Szikora, Istvan [21 ]
Pierot, Laurent [22 ]
Cognard, Christophe [8 ]
机构
[1] Bicetre Hosp, Assitance Publ Hop Paris, NEURI Brain Vasc Ctr Intervent Neuroradiol, Le Kremlin Bicetre, France
[2] Paris Saclay Univ, Fac Med, Le Kremlin Bicetre, France
[3] Hop Gui De Chauliac, Dept Intervent Neuroradiol, Montpellier, France
[4] Univ klinikum Schleswig Holstein, Dept Neuroradiol, Kiel, Germany
[5] Ruhr Univ Bochum, Dept Neuroradiol, Univ klinikum Knappschaftskrankenhaus Bochum, Med Fak, Bochum, Germany
[6] CHU Tours, Dept Neuroradiol, Tours, France
[7] Univ Klinikum Heidelberg, Dept Neuroradiol, Heidelberg, Germany
[8] Pierre Paul Riquet Hosp, Dept Diagnost & Therapeut Neuroradiol, Toulouse, France
[9] CHU Rouen, Dept Intervent Neuroradiol, Rouen, France
[10] HELIOS Klin, Dept Neuroradiol, Erfurt, Germany
[11] Univ Helsinki, Dept Neuroradiol, Cent Hosp, Helsinki, Finland
[12] Turku Univ Hosp, Dept Radiol, Turku, Finland
[13] Univ Hosp Augsburg, Dept Neuroradiol, Augsburg, Germany
[14] Edinburgh Royal Infirm, Dept Clin Neurosci, Edinburgh, Scotland
[15] Univ Edinburgh, Dept Clin Neurosci, Div Clin & Surg Sci, Edinburgh, Scotland
[16] Univ Med Ctr Hamburg Eppendorf, Dept diagnost & Intervent Neuroradiol, Hamburg, Germany
[17] Ludwig Maximilian Univ Hosp, Dept Neuroradiol, Munich, Germany
[18] CHU Poitiers, Dept Radiol, Poitiers, France
[19] Bicetre Hosp, Assitance Publ Hop Paris, Clin Res unit, Le Kremlin Bicetre, France
[20] John Radcliffe Hosp, Dept Neuroradiol, Oxford, England
[21] Natl Inst Neurosci, Dept Neuroradiol, Budapest, Hungary
[22] Reims Champagne Ardenne Univ, Maison Blanche Hosp, Dept Neuroradiol, Reims, France
关键词
Aneurysm; Angiography; Device; Intervention; Subarachnoid; SAFETY;
D O I
10.1136/jnis-2024-021918
中图分类号
R445 [影像诊断学];
学科分类号
100207 ;
摘要
Background The Woven EndoBridge (WEB) device is designed to treat wide-necked bifurcation aneurysms. The WEB 17 is the latest iteration and can be delivered through a 0.017 '' microcatheter. The CLEVER study demonstrated that WEB 17 is safe and effective for providing protection against bleeding or rebleeding at 1 month and 1 year. Objective To evaluate angiographic stability at 1 year. Methods The CLEVER study was a prospective multicenter study conducted in 17 European centers, involved 163 subjects, comprising 60 ruptured and 103 unruptured aneurysms. Independent assessment of 1-year follow-up imaging was incorporated into the study design. Results Aneurysm diameters ranged from 2.0 to 9.2 mm, with 95.7% being broad-based (dome-to-neck ratio <2). Follow-up imaging at 1 year was completed for 146 out of 163 subjects (89.6%) and evaluated by an independent core laboratory. The primary efficacy endpoint of adequate occlusion without re-treatment at 1 year was achieved for 120 (82.2%) of all subjects. At 1 year, the adequate occlusion rate was 86.5% for ruptured aneurysms (73.1% complete occlusion) and 82.4% for unruptured aneurysms (57.1% complete occlusion). The overall re-treatment rate at 1 year was 2.6% (4/152), with 3.1% (3/97) for unruptured aneurysms and 1.8% (1/55) for ruptured aneurysms Conclusion Delivery of the WEB 17 via 0.017 inch catheters represents a significant evolution of the WEB design. The results of CLEVER presented here demonstrate that it maintains the same efficacy as previous generations of WEB.
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