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SNIS 20th annual meeting electronic poster abstracts
E-015 Comparing woven endobridge (WEB) treatment outcomes between ruptured and unruptured aneurysms: a systematic review and meta-analysis
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  1. S Mannam1,2,
  2. I Matache2,3,
  3. J Vivanco-Suarez2,
  4. S Ajmera2,
  5. G Sioutas2,
  6. M Salem2,
  7. B Jankowitz2,
  8. J Burkhardt2,
  9. V Srinivasan2
  1. 1Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
  2. 2Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
  3. 3Physiology, Carol Davila University of Medicine and Pharmacy, București, Romania

Abstract

Introduction The Woven EndoBridge (WEB) device is a nitinol mesh intrasaccular device that does not require the need for antiplatelet therapy, making it an appealing option for wide-necked aneurysms regardless of its rupture status. However, current literature has limited power to evaluate the differences in the efficacy and safety of WEB embolization for ruptured versus unruptured aneurysms.

Methods We performed a systematic review between January 1960 and October 2022, of all the studies in which the WEB device was used for the treatment of ruptured and unruptured aneurysms. The primary efficacy outcome was adequate occlusion after WEB implantation. The safety outcome was a composite of intraprocedural and device-related post-operative ischemic and hemorrhagic events. The data was analyzed with a random-effects meta-analysis of proportions, and statistical heterogeneity was assessed with I2 statistics.

Results A total of 22 studies with 858 unique aneurysms were included in our analysis. Of those, 486 (56%) aneurysms were ruptured, and 372 (44%) were unruptured. The adequate occlusion rate at the last follow-up was similar between ruptured (81% [95% CI 75–86%; I2=27%]) and unruptured (83% [95% CI 77–88%; I2=8%]; p subgroup difference=.24) aneurysms. The rate of safety events was similar between ruptured (8% [95% CI 6–12%; I2=32%]) and unruptured (6% [95% CI 3–9%; I2=0%]; p subgroup difference=.16) aneurysms.

Conclusion This systematic review with meta-analysis found that WEB embolization for ruptured and unruptured aneurysms is safe and effective, with similar radiographic and safety outcomes in both scenarios. The use of the WEB device may reduce the need for open surgical procedures for complex aneurysms, leading to shorter hospital stays and faster recovery times for patients. The evidence of our findings suggests that this device can be a valuable option for complex ruptured and unruptured aneurysms.

Abstract E-015 Figure 1
Abstract E-015 Figure 1

Forest plot for adequate occlusion

Abstract E-015 Figure 2
Abstract E-015 Figure 2

Forest plot for safety events

Disclosures S. Mannam: None. I. Matache: None. J. Vivanco-Suarez: None. S. Ajmera: None. G. Sioutas: None. M. Salem: None. B. Jankowitz: None. J. Burkhardt: None. V. Srinivasan: None.

https://doi.org/10.1136/jnis-2023-SNIS.115

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