Background and purpose We performed a meta-analysis of existing literature on the Woven EndoBridge (WEB) device in treatment of intracranial aneurysms.

Method A comprehensive literature search of the databases PubMed, Ovid MEDLINE and Ovid EMBASE was designed and conducted by an experienced librarian with input from the authors. We extracted the information including aneurysm rupture status, mean aneurysm size, mean aneurysm neck size, length of clinical follow-up, and length of angiographic follow-up. Outcomes studied included immediate and long-term (>3 month) angiographic outcomes (complete occlusion, as well as adequate occlusion defined as complete occlusion or neck remnant), aneurysm retreatment, intraoperative rupture, perioperative morbidity and mortality, thromboembolic complication, and treatment failure. The meta-analysis was performed with the statistical package Comprehensive Meta-Analysis.

Results A total of 14 studies were included in this analysis, including 543 patients with 557 aneurysms, of which 127 were ruptured. Treatment failure occurred in 3% of cases (95% confidence interval [CI], 2%–5%). Perioperative morbidity and mortality rates were 5% (95% CI, 2%–7%) and 1% (95% CI, 0%–2%), respectively. Initial complete occlusion rates and adequate occlusion rates were 27% (95% CI, 15%–39%) and 58% (95% CI, 36%–79%), respectively. Complete occlusion and adequate occlusion rates at follow-up were 39% (95% CI, 26%–52%) and 80% (95% CI, 75%–85%), respectively.

Conclusions Early data suggests that WEB treatment has an excellent safety profile and promising rates of adequate occlusion, especially given the complexity of aneurysms treated. Further prospective clinical registries and trials are needed to confirm these results and better define the risks and benefits of the use of the WEB device in treatment wide-necked and wide-neck bifurcation aneurysms.

Disclosures W. Brinjikji: None. S. Asnafi: None. A. Rouchaud: None. L. Pierot: 1; C; Sequent. D. Kallmes: 1; C; Sequent.