Woven EndoBridge 17 device for intracranial aneurysms: A systematic review and meta-analysis

Background The Woven EndoBridge 17 (WEB-17) is the latest advancement in the WEB device family. Comprehensive data on its occlusion rates, procedural complications, and mortality is lacking. This meta-analysis aimed to evaluate the efficacy and safety of the WEB-17 device in intracranial aneurysms (IAs). Methods A systematic literature search was conducted from inception to October 2023 across four databases for studies on IAs treated with WEB 17. Primary outcomes included adequate angiographic occlusion at last follow-up and a composite of intraprocedural and postprocedural complications. Comparative meta-analysis between WEB-17 and its predecessor versions (pvWEB) was performed. Subgroup analyses by IA rupture status were also conducted for the primary outcomes. Results Eleven studies with 880 patients and 933 IAs were included. Regarding efficacy, the rate of adequate occlusion at last follow-up was 91% (95% CI 86%-94%) and the complete occlusion rate was 69% (95% CI 65%-73%). Safety outcomes demonstrated a composite complication rate of 7% (95% CI 4%-11%), an intraprocedural complication rate of 7% (95% CI 5%-9%; I2 = 0%), and a postprocedural complication rate of 2% (95% CI 1%-5%; I2 = 0%). No differences were found between WEB-17 and pvWEB in terms of adequate occlusion (WEB-17: 87.7% vs pvWEB: 80.4%; OR = 1.35, 95% CI 0.71-2.55) and safety composite outcome (WEB-17: 8.7% vs pvWEB: 10%; OR = 1.05, 95% CI 0.51-2.16). Subgroup analysis did not evidence heterogeneity between subgroups. Conclusions The WEB-17 device demonstrates promising efficacy and safety profiles for the treatment of IAs. However, these results should be interpreted with caution due to the limited quality of evidence in the included studies. Further prospective, randomized studies are needed to validate these findings.