• Nicola Limbucci, Giuseppe Leone, Andrea Rosi, Arturo Consoli, Leonardo Renieri, Antonio Laiso, Carlo Cirelli, Andrea Wlderk, Sergio Nappini, and Salvatore Mangiafico.
• Neurovascular Interventional Unit, Careggi University Hospital, Florence, Italy. Electronic address: nicolalimb@gmail.com.
• World Neurosurg. 2018 Jan 1; 109: e183-e193.

BackgroundThe experience with Woven EndoBridge (WEB) device is still limited. The aim of this study is to discuss the efficacy of this new device, focusing on any anatomical and procedural factors influencing aneurysm occlusion.MethodsBetween October 2011 and November 2016, 24 patients (10 female, 14 male) harboring 24 cerebral aneurysms treated with WEB in a single center were retrospectively reviewed. Patients underwent 6-month and 12- to 24-month (median 18 months) clinical and neuroradiologic follow-up. We evaluated whether any procedural or anatomical aspect influenced the occlusion rate.ResultsAdequate occlusion (AO) was achieved in 68% of cases at 6 months' and in 87% at 18 months' follow-up respectively. Technical difficulties occurred in 3 procedures (12.5%). No postprocedural morbidity was reported. One patient (4%) died after 1 month for reasons unrelated to the procedure. Neck size and dome-to-neck ratio were significantly associated with aneurysm occlusion (P < 0.05). AO was not associated with postoperative dual antiplatelet therapy (P > 0.99) or device compression at both first and second follow-up (P > 0.99). Immediate contrast agent stagnation was more common in aneurysms that were occluded at first (P = 0.37) and second follow-up (P = 0.24), but statistical significance was not reached.ConclusionsEndovascular treatment with WEB is a safe treatment for unruptured cerebral aneurysms, also resulting in a good AO rate in aneurysms that would otherwise require complex assisted coiling techniques. However, results are less favorable in cases of very large aneurysmal neck. Nevertheless, further series with larger patient populations and longer follow-up will define the role of WEB in the treatment of aneurysms.Copyright © 2017 Elsevier Inc. All rights reserved.

21 keywords...

hide…