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Aneurysm Treatment With Woven EndoBridge in the Cumulative Population of 3 Prospective, Multicenter Series: 2-Year Follow-Up.

Authors
  • Pierot, Laurent1
  • Moret, Jacques2
  • Barreau, Xavier3
  • Szikora, Istvan4
  • Herbreteau, Denis5
  • Turjman, Francis6
  • Holtmannspötter, Markus7
  • Januel, Anne-Christine8
  • Costalat, Vincent9
  • Fiehler, Jens10
  • Klisch, Joachim11
  • Gauvrit, Jean-Yves12
  • Weber, Werner13
  • Desal, Hubert14
  • Velasco, Stéphane15
  • Liebig, Thomas16
  • Stockx, Luc17
  • Berkefeld, Joachim18
  • Molyneux, Andrew19
  • Byrne, James V19
  • And 1 more
  • 1 Department of Neuroradiology, Hôpital Maison-Blanche, Université Reims-Champagne-Ardenne, Reims, France. , (France)
  • 2 Department of Neuroradiology, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France. , (France)
  • 3 Department of Neuroradiology, CHU Bordeaux, Bordeaux, France. , (France)
  • 4 Department of Neuroradiology, National Institute of Clinical Neurosciences, Budapest, Hungary. , (Hungary)
  • 5 Department of Neuroradiology, CHU Tours, Tours, France. , (France)
  • 6 Department of Neuroradiology, CHU Lyon, Lyon, France. , (France)
  • 7 Department of Neuroradiology, Rigshospitalet, Copenhagen, Denmark. , (Denmark)
  • 8 Department of Neuroradiology, CHU Toulouse, Toulouse, France. , (France)
  • 9 Department of Neuroradiology, CHU Montpellier, Montpellier, France. , (France)
  • 10 Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. , (Germany)
  • 11 Department of Neuroradiology, Helios General Hospital, Erfurt, Germany. , (Germany)
  • 12 Department of Neuroradiology, CHU Rennes, Rennes, France. , (France)
  • 13 Department of Neuroradiology, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Germany. , (Germany)
  • 14 Department of Neuroradiology, CHU Nantes, Nantes, France. , (France)
  • 15 Department of Neuroradiology, CHU Poitiers, Poitiers, France. , (France)
  • 16 Institut of Neuroradiology, Ludwig-Maximilian University Hospital, Munich, Germany. , (Germany)
  • 17 Department of Neuroradiology, ZOL (Ziekenhuis Oost-Limburg) Genk, Genk, Belgium. , (Belgium)
  • 18 Department of Neuroradiology, Institut für Neuroradiologie, Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt, Germany. , (Germany)
  • 19 Department of Neuroradiology, Nuffield Department of Surgical Sciences, Oxford University, Oxford, United Kingdom. , (United Kingdom)
Type
Published Article
Journal
Neurosurgery
Publication Date
Aug 01, 2020
Volume
87
Issue
2
Pages
357–367
Identifiers
DOI: 10.1093/neuros/nyz557
PMID: 31960052
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Woven EndoBridge (WEB; Sequent Medical) treatment is an innovative endovascular approach for treatment of wide-neck bifurcation aneurysms. Initial studies have shown high safety with good efficacy at short term confirmed by trials conducted in United States (WEB-Intrasaccular Therapy) and in Europe (WEB Clinical Assessment of Intrasaccular Aneurysm Therapy [WEBCAST], French Observatory, and WEBCAST-2). To report the 2-yr clinical and anatomical results of WEB treatment in the combined population of 3 European trials. In a French Observatory, 2-yr clinical and anatomical data were collected. In WEBCAST and WEBCAST-2, 2-yr follow-up was optional, and data were collected when follow-up was performed. Aneurysm occlusion was evaluated using a 3-grade scale: complete occlusion, neck remnant, and aneurysm remnant. The population for safety was 138/168 patients (82.1%), including 89 females (64.5%), with mean age of 55.5 ± 10.2 yr. The population for efficacy was 121/169 aneurysms (71.6%). Aneurysm locations were middle cerebral artery in 65/121 aneurysms (53.7%), anterior-communicating artery in 25/121 (20.7%), basilar artery in 17/121 (14.0%), and internal carotid artery terminus in 14/121 (11.6%). No clinically relevant adverse events occurred between years 1 and 2. At 2 yr, complete occlusion was observed in 62/121 (51.2%) aneurysms, neck remnant in 36/121 (29.8%) aneurysms, and aneurysm remnant in 23/121 (19.0%) aneurysms. The global retreatment rate at 2 yr was 9.3%. This analysis confirms the high safety profile of WEB treatment at 2 yr. Aneurysm occlusion is generally stable at 2 yr, and the retreatment rate between 1 yr and 2 yr is low (2.0%). © Congress of Neurological Surgeons 2020.

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