• Christoph Kabbasch, Lukas Goertz, Eberhard Siebert, Moriz Herzberg, Jan Borggrefe, Boris Krischek, Pantelis Stavrinou, Franziska Dorn, and Thomas Liebig.
• Department of Neuroradiology, University Hospital of Cologne, Cologne, Germany.
• J Neurointerv Surg. 2019 Aug 1; 11 (8): 812-816.

BackgroundIntrasaccular flow disruption represents a new paradigm in endovascular treatment of wide-necked bifurcation aneurysms.ObjectiveTo perform a matched case-control study comparing complications and angiographic outcome using the Woven Endobridge (WEB) device and stent-assisted coiling (SAC).MethodsSixty-six patients treated with the WEB at three German tertiary care centers were included and matched with 66 patients treated with SAC based on aneurysm location and unruptured/ruptured aneurysm status. Parameters were retrospectively analysed and compared between the treatment groups using inverse probability of treatment weighting (IPTW) with propensity scores.ResultsProcedural complication rates were 12.1% in the WEB group and 21.2% in the SAC group, which was statistically significant after IPTW adjustment (OR=2.2, 95% CI 1.08 to 4.4, p=0.03). Favourable outcome (modified Rankin scale score ≤2) was achieved by 57/66 (86.4%) in the WEB group and 57/66 (86.4%) in the SAC group (p=1.0). At mid-term follow-up, a similar number of aneurysms achieved adequate occlusion (complete occlusion or neck remnant) in the WEB group (93.9%) and in the SAC group (93.9%, p=1.0). Re-treatment was performed in 10.6% after WEB embolization and 12.1% after SAC (p=1.0).ConclusionsThe WEB provides similar mid-term aneurysm occlusion rates to those of SAC, with no additional morbidity and potentially lower complication rates. Long-term outcome analysis will provide a definite conclusion on the use of WEB for intracranial aneurysms.© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

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