The safety and effectiveness of the Woven EndoBridge (WEB) system for the treatment of wide-necked bifurcation aneurysms: final 12-month results of the pivotal WEB Intrasaccular Therapy (WEB-IT) Study

被引:276
作者
Arthur, Adam S. [1 ,2 ]
Molyneux, Andy [3 ]
Coon, Alexander L. [4 ]
Saatci, Isil [5 ,19 ]
Szikora, Istvan [6 ,20 ]
Baltacioglu, Feyyaz [7 ,21 ]
Sultan, Ali [8 ,22 ]
Hoit, Daniel [1 ,2 ,15 ,16 ,31 ]
Almandoz, Josser E. Delgado [9 ]
Elijovich, Lucas [1 ,10 ,15 ,16 ,31 ]
Cekirge, Saru [11 ,12 ]
Byrne, James, V [13 ]
Fiorella, David [14 ,17 ]
Arthur, Adam [15 ,16 ,31 ]
Woo, Henry [17 ]
Coon, Alexander [18 ]
Colby, Geoffrey [18 ]
Cekirge, Saruhan [19 ]
Asadov, Ruslan [21 ]
Chavali, Ram [22 ]
Frerich, Kai [22 ]
Delgado, Josser [23 ]
Kayan, Yasha [23 ]
Hanel, Ricardo [24 ]
Sauvageau, Eric [24 ]
Turner, Raymond [25 ]
Chaudry, Imran [25 ]
Spiotta, Alejandro [25 ]
Turk, Aquila [25 ]
Rai, Ansaar [26 ]
Carpenter, Jeffrey [26 ]
Boo, Sohyun [26 ]
Jabbour, Pascal [27 ]
Tjoumakaris, Stavropoula [27 ]
Rosenwasser, Robert [27 ]
Woodward, Keith [28 ]
Boulos, Alan [29 ]
Dalfino, John [29 ]
Yamamoto, Junichi [29 ]
Vora, Nirav [30 ]
Budzik, Ronald [30 ]
Pema, Peter [30 ]
Davis, Thomas [30 ]
Kallmes, David [32 ]
Lanzino, Giuseppe [32 ]
Cloft, Harry [32 ]
Siddiqui, Adnan [33 ]
Levy, Elad [33 ]
Snyder, Kenneth [33 ]
Lopes, Demetrius [34 ]
机构
[1] Semmes Murphey Neurol & Spine Inst, Memphis, TN USA
[2] Univ Tennessee, Hlth Sci Ctr, Neurosurg, Memphis, TN USA
[3] Univ Oxford, Nuffield Dept Surg Sci, Neurovasc & Neuroradiol Res Unit, Oxford, Oxon, England
[4] Johns Hopkins Univ, Neurosurg, Baltimore, MD USA
[5] Private Koru Hosp, Ankara, Turkey
[6] Natl Inst Clin Neurosci, Budapest, Hungary
[7] Marmara Univ, Egitim & Arastirma Hastanesi, Neuroradiol, Istanbul, Turkey
[8] Brigham & Womens Hosp, Neurosurg, 75 Francis St, Boston, MA 02115 USA
[9] Abbott NW Hosp, Intervent Neuroradiol, Minneapolis, MN USA
[10] Univ Tennessee, Hlth Sci Ctr, Neurol Neurosurg, Memphis, TN USA
[11] Koru Hosp, Radiol, Ankara, Turkey
[12] Saruhan Cekirge, Private Off, Ankara, Turkey
[13] John Radcliffe Hosp, Neuroradiol, Oxford, Oxon, England
[14] Stony Brook Univ Hosp, Stony Brook, NY USA
[15] Methodist Univ Hosp, Neurosci Inst, Memphis, TN USA
[16] Methodist Univ Hosp, Canc Ctr, Memphis, TN USA
[17] SUNY Stony Brook, Med Ctr, Stony Brook, NY 11794 USA
[18] Johns Hopkins Univ Hosp, Baltimore, MD USA
[19] Koru Hosp, Ankara, Turkey
[20] Natl Inst Neurosci, Budapest, Hungary
[21] Marmara Univ, Fac Med, Pendik Training & Res Hosp, Istanbul, Turkey
[22] Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA
[23] Abbott NW Hosp, Minneapolis, MN USA
[24] Baptist Med Ctr, Lyerly Neurosurg, Jacksonville, FL USA
[25] Med Univ South Carolina, Charleston, SC 29425 USA
[26] West Virginia Univ, Med Ctr, Morgantown, WV 26506 USA
[27] Thomas Jefferson Univ Hosp, Philadelphia, PA 19107 USA
[28] Ft Sanders Reg Med Ctr, Knoxville, TN USA
[29] Albany Med Ctr, Albany, NY USA
[30] Riverside Methodist Hosp, Columbus, OH 43214 USA
[31] Baptist Mem Hosp, Memphis, TN 38146 USA
[32] Mayo Clin, Rochester, MN USA
[33] Univ Buffalo, Med Ctr, Buffalo, NY USA
[34] Rush Univ, Med Ctr, Chicago, IL 60612 USA
[35] Mt Sinai Roosevelt Hosp, New York, NY USA
[36] Univ Texas Houston, Sch Med, Houston, TX USA
[37] Royal Univ Hosp, Saskatoon, SK, Canada
[38] Swedish Med Ctr, Englewood, CO 80110 USA
[39] St Josephs Hosp, Barrow Neurol Inst, Phoenix, AZ USA
[40] Univ Copenhagen, Righosp, Copenhagen, Denmark
[41] Univ Louisville Hosp, Louisville, KY USA
[42] Helios Gen Hosp, Erfurt, Germany
关键词
PIPELINE EMBOLIZATION DEVICE; STENT-ASSISTED COILING; INTRACRANIAL ANEURYSMS; CEREBRAL ANEURYSMS; ENDOVASCULAR TREATMENT; FOLLOW-UP; COMPLICATIONS; COHORT;
D O I
10.1136/neurintsurg-2019-014815
中图分类号
R445 [影像诊断学];
学科分类号
100207 ;
摘要
Introduction The Woven EndoBridge Intrasaccular Therapy (WEB-IT) Study is a pivotal, prospective, singlearm, investigational device exemption study designed to evaluate the safety and effectiveness of the WEB device for the treatment of wide-neck bifurcation aneurysms. Methods One-hundred and fifty patients with wideneck bifurcation aneurysms were enrolled at 21 US and six international centers. Angiograms from the index procedure, and 6-month and 1-year follow-up visits were all reviewed by a core laboratory. All adverse events were reviewed and adjudicated by a clinical events adjudicator. A data monitoring committee provided oversight during the trial to ensure subject safety. Results One-hundred and forty-eight patients received the WEB implant. One (0.7%) primary safety event occurred during the study-a delayed ipsilateral parenchymal hemorrhage-on postoperative day 22. No primary safety events occurred after 30 days through 1 year. At the 12-month angiographic follow-up, 77/143 patients (53.8%) had complete aneurysm occlusion. Adequate occlusion was achieved in 121/143 (84.6%) subjects. Conclusions The prespecified safety and effectiveness endpoints for the aneurysms studied in the WEB-IT trial were met. The results of this trial suggest that the WEB device provides an option for patients with wide-neck bifurcation aneurysms that is as effective as currently available therapies and markedly safer.
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收藏
页码:924 / 930
页数:7
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