Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series

Laurent Pierot, Jacques Moret, Xavier Barreau, Istvan Szikora, Denis Herbreteau, Francis Turjman, Markus Holtmannspötter, Anne Christine Januel, Vincent Costalat, Jens Fiehler, Joachim Klisch, Jean Yves Gauvrit, Werner Weber, Hubert Desal, Stéphane Velasco, Thomas Liebig, Luc Stockx, Joachim Berkefeld, Andrew Molyneux, James ByrneLaurent Spelle

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62 Citations (Scopus)

Abstract

Background: Flow disruption with the WEB is an innovative endovascular approach for treatment of wideneck bifurcation aneurysms. Initial studies have shown a low complication rate with good efficacy. Purpose To report clinical and anatomical results of the WEB treatment in the cumulative population of three Good Clinical Practice (GCP) studies: WEBCAST (WEB Clinical Assessment of Intrasaccular Aneurysm), French Observatory, and WEBCAST-2. Methods: WEBCAST, French Observatory, and WEBCAST-2 are single-arm, prospective, multicenter, GCP studies dedicated to the evaluation of WEB treatment. Clinical data were independently evaluated. Postoperative and 1-year aneurysm occlusion was independently evaluated using the 3-grade scale: complete occlusion, neck remnant, and aneurysm remnant. Results: The cumulative population comprised 168 patients with 169 aneurysms, including 112 female subjects (66.7%). The patients' ages ranged between 27 and 77 years (mean 55.5±10.2 years). Aneurysm locations were middle cerebral artery in 86/169 aneurysms (50.9%), anterior communicating artery in 36/169 (21.3%), basilar artery in 30/169 (17.8%), and internal carotid artery terminus in 17/169 (10.1%). The aneurysm was ruptured in 14/169 (8.3%). There was no mortality at 1 month and procedure/devicerelated morbidity was 1.2% (2/168). At 1 year, complete aneurysm occlusion was observed in 81/153 aneurysms (52.9%), neck remnant in 40/153 aneurysms (26.1%), and aneurysm remnant in 32/153 aneurysms (20.9%). Re-treatment was carried out in 6.9%. Conclusions: This series is at the moment the largest prospective, multicenter, GCP series of patients with aneurysms treated with WEB. It shows the high safety and good mid-term efficacy of this treatment.

Original languageEnglish
Pages (from-to)556-562
Number of pages7
JournalJournal of neurointerventional surgery
Volume10
Issue number6
DOIs
Publication statusPublished - Jun 2018

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Pierot, L., Moret, J., Barreau, X., Szikora, I., Herbreteau, D., Turjman, F., Holtmannspötter, M., Januel, A. C., Costalat, V., Fiehler, J., Klisch, J., Gauvrit, J. Y., Weber, W., Desal, H., Velasco, S., Liebig, T., Stockx, L., Berkefeld, J., Molyneux, A., ... Spelle, L. (2018). Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series. Journal of neurointerventional surgery, 10(6), 556-562. https://doi.org/10.1136/neurintsurg-2017-013448