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Abstract
Background The Woven EndoBridge (WEB) device has Food and Drug Administration approval for treatment of wide-necked intracranial bifurcation aneurysms. The WEB device has been shown to result in adequate occlusion in bifurcation aneurysms overall, but its usefulness in the individual bifurcation locations has been evaluated separately only in few case series, which were limited by small sample sizes.
Objective To compare angiographic and clinical outcomes after treatment of bifurcation aneurysms at various locations, including anterior communicating artery (AComA), anterior cerebral artery (ACA) bifurcation distal to AComA, basilar tip, internal carotid artery (ICA) bifurcation, and middle cerebral artery (MCA) bifurcation aneurysms using the WEB device.
Methods A retrospective cohort analysis was conducted at 22 academic institutions worldwide to compare treatment outcomes of patients with intracranial bifurcation aneurysms using the WEB device. Data include patient and aneurysm characteristics, procedural details, angiographic and functional outcomes, and complications.
Results A total of 572 aneurysms were included. MCA (36%), AComA (35.7%), and basilar tip (18.9%) aneurysms were most common. The rate of adequate aneurysm occlusion was significantly higher for basilar tip (91.6%) and ICA bifurcation (96.7%) aneurysms and lower for ACA bifurcation (71.4%) and AComA (80.6%) aneurysms (p=0.04).
Conclusion To our knowledge, this is the most extensive study to date that compares the treatment of different intracranial bifurcation aneurysms using the WEB device. Basilar tip and ICA bifurcation aneurysms showed significantly higher rates of aneurysm occlusion than other locations.
- Aneurysm
Data availability statement
Data are available upon reasonable request.
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Data availability statement
Data are available upon reasonable request.
Footnotes
Twitter @docd88, @AhmadSweidMD, @GuenegoAdrien, @eneri_neuro, @Starke_neurosurgery, @AjitSPuri1, @cgriessenauer, @PeterKa80460001, @VladoKZg, @PascalJabbourMD
Contributors All authors have contributed to study through conception of the idea, data collection, draft, and/or review of final version as follows: Conception, draft writing, data collection, final version revision: NA, MD, JDBD, KP, AAD. Data collection, supervision, final version revision: HHC-S, AS, SVL, AG, AA, LR, SHS, GS, MAM, RWR, JEV, IL, PF, JAV, VZ, MUF, CR, MW, VMT, JDR, YR, CMS, MP, ALK, CM, SE, RMS, AEH, AHS, AB, MajM, JJ, MP, JS, BL, PP, ASP, GP, CJG, HA, AS, AFD, FCA, RD, PK, VK, PL, CJS, SB, JK, MAA-S, NL, PJ, CC, ABP.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests The following authors serve on the editorial board of JNIS, JDBD, AG, AFD, FCA, and PK.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.
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