Factors that determine aneurysm occlusion after embolization with the Woven EndoBridge (WEB)

Kabbasch, Christoph; Goertz, Lukas; Siebert, Eberhard; Herzberg, Moriz; Borggrefe, Jan; Dorn, Franziska and Liebig, Thomas (2019): Factors that determine aneurysm occlusion after embolization with the Woven EndoBridge (WEB). In: Journal of Neurointerventional Surgery, Vol. 11, No. 5: pp. 503-510

Abstract

Background The Woven EndoBridge (WEB) device is a novel endovascular tool for the treatment of wide-necked intracranial aneurysms. Objective To evaluate factors influencing aneurysm occlusion and aneurysm recurrence after WEB embolization. Methods A total of 113 patients (mean age 58.9 +/- 11.9 years) with 114 aneurysms (mean size 8.6 +/- 4.6 mm) were successfully treated with the WEB device at three German tertiary care centers between May 2011 and February 2018. Aneurysm occlusion was evaluated using the Raymond-Roy occlusion classification. We retrospectively collected patient characteristics, anatomical details, and procedural aspects and evaluated their impact on aneurysm occlusion and recurrence. Results Of 98 patients available for a 6-month angiographic follow-up, complete occlusion was achieved in 62.2%, neck remnants in 21.4%, and aneurysm remnants in 16.3%. Aneurysm recurrence occurred in 15.3%. Initial partial aneurysm thrombosis, recurrent aneurysms, aneurysm size, and simultaneous treatment by WEB and coil were associated with aneurysm remnants (p<0.05). Initial partial aneurysm thrombosis, increasing aneurysm size, and treatment by WEB and coil also predicted aneurysm recurrence (p<0.05). In the subgroup analysis of 71 aneurysms treated with WEB only, initial incomplete occlusion and male sex were associated with aneurysm remnants (p<0.05), while aneurysm height correlated with aneurysm recurrence (p=0.008). Conclusions The WEB provides a high rate of adequate occlusion even in a subset of complex wide-necked intracranial aneurysms. Anatomic results tend to be less favourable in large and partially thrombosed aneurysms and after treatment with WEB and coil.

• Item Type: Journal article
• Faculties: Medicine
• Subjects: 600 Technology > 610 Medicine and health
• ISSN: 1759-8478
• Alliance/National Licence: This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
• Language: English