Predictors of aneurysm occlusion following treatment with the WEB device: systematic review and case series

Fadi Al Saiegh, Lohit Velagapudi, Omaditya Khanna, Ahmad Sweid, Nikolaos Mouchtouris, Michael P. Baldassari, Thana Theofanis, Rizwan Tahir, Victoria Schunemann, Carrie Andrews, Lucas Philipp, Nohra Chalouhi, Stavropoula I. Tjoumakaris, David Hasan, M. Reid Gooch, Nabeel A. Herial, Robert H. Rosenwasser, Pascal Jabbour

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations

Abstract

The Woven EndoBridge (WEB) device is becoming increasingly popular for treatment of wide-neck aneurysms. As experience with this device grows, it is important to identify factors associated with occlusion following WEB treatment to guide decision making and screen patients at high risk for recurrence. The aim of this study was to identify factors associated with adequate aneurysm occlusion following WEB device treatment in the neurosurgical literature and in our case series. A systematic review of the present literature was conducted to identify studies related to the prediction of WEB device occlusion. In addition, a retrospective review of our institutional data for patients treated with the WEB device was performed. Demographics, aneurysm characteristics, procedural variables, and 6-month follow-up angiographic outcomes were recorded. Seven articles totaling 450 patients with 456 aneurysms fit our criteria. Factors in the literature associated with inadequate occlusion included larger size, increased neck width, partial intrasaccular thrombosis, irregular shape, and tobacco use. Our retrospective review identified 43 patients with 45 aneurysms. A total of 91.1% of our patients achieved adequate occlusion at a mean follow-up time of 7.32 months. Increasing degree of contrast stasis after WEB placement on the post-deployment angiogram was significantly associated with adequate occlusion on follow-up angiogram (p = 0.005) and with Raymond-Roy classification (p = 0.048), but not with retreatment (p = 0.617). In our systematic review and case series totaling 450 patients with 456 aneurysms, contrast stasis on post-deployment angiogram was identified as a predictor of adequate aneurysm occlusion, while morphological characteristics such as larger size and wide neck negatively impact occlusion.

Original languageEnglish (US)
Pages (from-to)925-936
Number of pages12
JournalNeurosurgical Review
Volume45
Issue number2
DOIs
StatePublished - Apr 2022
Externally publishedYes

Keywords

  • Aneurysm
  • Endovascular
  • Occlusion
  • WEB device

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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