The Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: Ten Years of Lessons Learned and Adjustments in Practice from the WorldWideWEB Consortium

被引：14

作者：

Dmytriw, Adam A. ^{[1
,2
,3
,4
]}

Dibas, Mahmoud ^{[1
,2
]}

Ghozy, Sherief ^{[5
]}

Adeeb, Nimer ^{[6
]}

Diestro, Jose Danilo Bengzon ^{[7
]}

Phan, Kevin ^{[21
]}

Cuellar-Saenz, Hugo H. ^{[6
]}

Sweid, Ahmad ^{[8
]}

Lay, Sovann, V ^{[9
]}

Guenego, Adrien ^{[8
]}

Renieri, Leonardo ^{[10
]}

Al Balushi, Ali ^{[11
]}

Saliou, Guillaume ^{[12
]}

Moehlenbruch, Markus ^{[13
]}

Regenhardt, Robert W. ^{[3
,4
]}

Vranic, Justin E. ^{[3
,4
]}

Lylyk, Ivan ^{[14
]}

Foreman, Paul M. ^{[15
]}

Vachhani, Jay A. ^{[15
]}

Zupancic, Vedran ^{[16
]}

Hafeez, Muhammad U. ^{[17
,18
]}

Rutledge, Caleb ^{[19
]}

Waqas, Muhammad ^{[20
]}

Tutino, Vincent M. ^{[20
]}

Rabinov, James D. ^{[3
,4
]}

Ren, Yifan ^{[21
]}

Schirmer, Clemens M. ^{[22
]}

Piano, Mariangela ^{[23
]}

Kuhn, Anna L. ^{[24
]}

Michelozzi, Caterina ^{[25
]}

Elens, Stephanie ^{[26
]}

Starke, Robert M. ^{[27
]}

Hassan, Ameer ^{[28
]}

Salehani, Arsalaan ^{[29
,30
]}

Sporns, Peter ^{[31
]}

Jones, Jesse ^{[29
,30
]}

Psychogios, Marios ^{[31
]}

Spears, Julian ^{[7
]}

Lubicz, Boris ^{[26
]}

Panni, Pietro ^{[25
]}

Puri, Ajit S. ^{[24
]}

Pero, Guglielmo ^{[23
]}

Griessenauer, Christoph J. ^{[22
,32
,33
]}

Asadi, Flamed ^{[21
]}

Stapleton, Christopher J. ^{[3
,4
]}

Siddiqui, Adnan ^{[20
]}

Ducruet, Andrew F. ^{[19
]}

Albuquerque, Felipe C. L. ^{[19
]}

Du, Rose ^{[3
,4
]}

Kan, Peter ^{[17
,18
]}

机构：

[1] Western Univ, London Hlth Sci Ctr, Dept Med Imaging, Neurointervent Program, London, ON, Canada

[2] Western Univ, London Hlth Sci Ctr, Dept Clin Neurol Sci, Neurointervent Program, London, ON, Canada

[3] Harvard Med Sch, Massachusetts Gen Hosp, Neuroendovasc Program, 55 Fruit St, Boston, MA 02114 USA

[4] Harvard Med Sch, Brigham & Womens Hosp, 55 Fruit St, Boston, MA 02114 USA

[5] Mayo Clin, Dept Neuroradiol, Rochester, MN USA

[6] Louisiana State Univ, Dept Neurosurg & Neurointervent Surg, Shreveport, LA 71105 USA

[7] Univ Toronto, Dept Radiol, Div Diagnost & Therapeut Neuroradiol, St Michaels Hosp, Toronto, ON, Canada

[8] Thomas Jefferson Univ, Dept Neurosurg, Philadelphia, PA 19107 USA

[9] Hop Purpan, Ctr Hosp Toulouse, Serv Neuroradiol Diagnost & Therapeut, Toulouse, France

[10] Osped Careggi Firenze, Interventist Neurovasc, Florence, Italy

[11] New York Presbyterian Hosp, Weill Cornell Sch Med, Neurosurg & Intervent Neuroradiol, New York, NY USA

[12] Ctr Hosp Vaudois Lausanne, Serv Radiodiagnost & Radiol Intervent, Lausanne, Switzerland

[13] Univ Klinikum Heidelberg, Sekt Vaskulare & Intervent Neuroradiol, Heidelberg, Germany

[14] Clin La Sagrada Familia, Equipo Neurocirugia Endovasc & Radiol Intervencio, Buenos Aires, DF, Argentina

[15] Orlando Hlth Neurosci & Rehabil Inst, Neurosurg Dept, Orlando, FL USA

[16] Clin Hosp Ctr Sisters Mercy, Dept Radiol, Subdiv Intervent Neuroradiol, Zagreb, Croatia

[17] UTMB, Dept Neurosurg, Houston, TX USA

[18] Baylor Sch Med, Houston, TX USA

[19] Barrow Neurol Inst, Dept Neurosurg, Phoenix, AZ 85013 USA

[20] SUNY Buffalo, Dept Neurosurg, Buffalo, NY USA

[21] Austin Hlth, Intervent Radiol & Neurointervent Serv, Dept Radiol, Melbourne, Vic, Australia

[22] Geisinger Hosp, Dept Neurosurg & Radiol, Danville, PA USA

[23] Osped Niguarda Ca Granda, Interventist Neurovasc, Milan, Italy

[24] UMass Mem Hosp, Dept Neurointervent Radiol, Worcester, MA USA

[25] Osped San Raffaele Milano, Interventist Neurovasc, Milan, Italy

[26] Hop Univ Erasme, Serv Neuroradiol Intervent, Brussels, Belgium

[27] Univ Miami, Dept Neurosurg, Miami, FL USA

[28] Valley Baptist Neurosci Inst, Dept Neurosci, Harlingen, TX USA

[29] Univ Alabama Birmingham, Dept Neurosurg, Birmingham, AL USA

[30] Univ Alabama Birmingham, Dept Radiol, Birmingham, AL USA

[31] Univ Med Ctr Hamburg Eppendorf, Dept Diagnost & Intervent Neuroradiol, Hamburg, Germany

[32] Paracelsus Med Univ Salzburg, Christian Doppler Univ Hosp, Dept Neurosurg, Salzburg, Austria

[33] Paracelsus Med Univ, Inst Neurointervent, Salzburg, Austria

来源：

TRANSLATIONAL STROKE RESEARCH | 2023年 / 14卷 / 04期

关键词：

Learning curve; Intracranial aneurysm; Endovascular; Intrasaccular; Woven EndoBridge; WEB; EMBOLIZATION; ACCESS; SERIES; SAFETY;

D O I：

10.1007/s12975-022-01072-x

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Several studies have shown promising outcomes of the Woven EndoBridge (WEB) device for the treatment of wide-necked intracranial bifurcation aneurysms. This is a multicenter study attempts to explore the changes in trends and treatment outcomes over time for WEB embolization of intracranial aneurysms. The WorldWideWEB consortium is a retrospective multicenter collaboration of data from international centers spanning from January 2011 and June 2021, with no limitations on aneurysm location or rupture status. Both bifurcation and sidewall aneurysms were included. These patients were stratified based on treatment year into five treatment intervals: 2011-2015 (N = 66), 2016-2017 (N = 77), 2018 (N = 66), 2019 (N = 300), and 2020-2021 (N = 173). Patient characteristics and angiographic and clinical outcomes were compared between these time intervals. This study comprised 671 patients (median age 61.4 years; 71.2% female) with 682 intracranial aneurysms. Over time, we observed an increasing tendency to treat patients presenting with ruptured aneurysms and aneurysms with smaller neck, diameter, and dome widths. Furthermore, we observed a trend towards more off-label use of the WEB for sidewall aneurysms and increased adoption of transradial access for WEB deployment. Moreover, the proportion of patients with adequate WEB occlusion immediately and at last follow-up was significantly higher in more recent year cohorts, as well as lower rates of compaction and retreatment. Mortality and complications did not differ over time. This learning curve study suggests improved experience using the WEB for the treatment of intracranial aneurysms and has yielded higher rates of adequate occlusion over time.

引用

页码：455 / 464

页数：10