Purpose WEB Flow disruption is an innovative endovascular treatment for wide-neck bifurcation aneurysms. This treatment was already evaluated in several retrospective and prospective series, including 2 Good Clinical Practice (GCP) studies (WEBCAST and French Observatory) showing high safety and good efficacy. In WEBCAST, all patients were treated with the first generation of the device (WEB-DL) and WEBCAST2 was initiated to evaluate the second generation of the device (WEB-SL and WEB-SLS).
Methods Patients with wide neck bifurcation aneurysm were included in WEBCAST2 if the aneurysm was not previously treated. An independent medical monitor independently analyzed adverse events. Follow-up imaging was obtained at 6 and 12 months up to 5 years after the procedure. An independent expert in Interventional Neuroradiology evaluated anatomical results using the 3 grades scale: complete occlusion, neck remnant, and aneurysm remnant.
Results From August 14 to May 15, 55 patients (38 females, 69.0%) with 55 aneurysms including 4 ruptured (7.2%) were included. Aneurysm locations were: middle cerebral artery in 25 patients (46.0%), anterior communicating artery in 16 patients (29.0%), basilar artery in 9 patients (16.0%), and internal carotid artery terminus in 5 patients (9.0%). Placement of the WEB device was feasible in 53/55 aneurysms (96.4%). Forty-seven aneurysms were treated with the WEB-SL and 6 with WEB-SLS. Adjunctive devices were used in 4 patients (7.3%). Procedure-related morbidity and mortality at one month were reported in 1/54 patients (1.8%) and 0/54 patients (0.0%), respectively (1 patient was missing one-month follow-up).
Anatomical results at 6 months were complete aneurysm occlusion in 28/49 aneurysms (57.1%), neck remnant in 11/49 aneurysms (22.4%), and aneurysm remnant in 10/49 aneurysms (20.4%).
Conclusion Preliminary results of WEBCAST2 show similar safety and efficacy of WEB-SL/SLS compared to WEB-DL (WEBCAST) with low morbidity and no mortality and a high rate of adequate occlusion (79.5%).
Disclosures L. Pierot: 2; C; Sequent. A. Molyneux: 2; C; Sequent. J. Byrne: 2; C; Sequent.
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