Article Text
Abstract
Introduction/Purpose Flow Disruption with WEB is an innovative endovascular approach for wide-neck bifurcation aneurysms that has been evaluated in 3 European Good Clinical Practice Studies: WEBCAST (WEB Clinical Assessment of Intrasaccular Aneurysm), French Observatory, and WEBCAST-2. This treatment is associated with a high safety and efficacy at one year.1 Long-term anatomical results have been very few evaluated. The present work is presenting the 2-years safety and efficacy results in the 3 GCP studies.
Materials and methods Out of the 168 patients with 169 aneurysms initially included in the 3 GCP studies, 138 patients were clinically evaluated at 2 years and 120 patients with 121 aneurysms were evaluated by vascular imaging.
Results There was no bleeding/rebleeding or thromboembolic complication between 1 year and 2 years. Morbidity and mortality at 2 years were 1.4% (2/138) and 5.1% (7/138), respectively. Two deaths (1.4%) were related to the procedure (retroperitoneal hematoma and brainstem compression). The other deaths were unrelated to the disease or the procedure (cancer: 3 patients; pneumonia: 1 patient; cirrhosis: 1 patient). Anatomical results at 2 years were complete occlusion in 62/121 aneurysms (51.2%), neck remnant in 36/121 aneurysms (29.8%), and aneurysm remnant in 23/121 aneurysms (19.0%). Anatomical results were similar in aneurysms treated with WEB DL and WEB SL/SLS. Between 1 and 2 years, aneurysm occlusion was stable or improved in 103/119 aneurysms (86.6%). Aneurysm retreatment was performed in 14 aneurysms (9.3%), 11 between the procedure and 1 year and in 3 between 1 and 2 years.
Conclusion The great safety and efficacy of WEB aneurysm treatment is confirmed at 2 years follow-up. No adverse events are observed between 1 year and 2 years. Adequate occlusion is observed in a similar percentage of aneurysms at 1 year (79.1%) and 2 years (81.0%). 1 Pierot L, Soize S, Molyneux A, Byrne J, Spelle. Evaluation of the Safety and Efficacy of Aneurysm Treatment with WEBTM device in the cumulated population of 3 prospective, multicenter series (WEBCAST, French Observatory, WEBCAST-2). J NeuroIntervent Surg. 2018;10:553–559.
Disclosures L. Pierot: 2; C; Balt, Medtronic, Microvention, Phenox, Vesalio. X. Barreau: None. I. Szikora: None. D. Herbreteau: None. J. Byrne: None. L. Spelle: None.