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The woven endoBridge (WEB) for endovascular therapy of intracranial aneurysms : update of a systematic review with meta-analysis.
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Tau, Noam, Sadeh-Gonik, Udi, Aulagner, Gilles, Turjman, Francis, Gory, Benjamin and Armoiry, Xavier (2018) The woven endoBridge (WEB) for endovascular therapy of intracranial aneurysms : update of a systematic review with meta-analysis. Clinical neurology and neurosurgery, 166 . pp. 110-115. doi:10.1016/j.clineuro.2018.01.025
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WRAP-Woven-endobridge-(WEB)-of-endovascular-therapy-Armoiry-2018.pdf - Accepted Version - Requires a PDF viewer. Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0. Download (642Kb) | Preview |
Official URL: http://dx.doi.org/10.1016/j.clineuro.2018.01.025
Abstract
Endovascular treatment of wide-neck intracranial aneurysms (IAs) is challenging, especially in bifurcation location. The intra-saccular flow-disruptor Woven EndoBridge (WEB) offers a new concept of endovascular therapy for wide-neck IAs. We performed an update of a systematic review aimed to report the feasibility, effectiveness and safety of WEB device therapy. A systematic review was conducted using several electronic databases (including PUBMED and EMBASE), searching for studies published between October 2015 and December 2017 (those published between January 2010 and September 2015 were included in our initial systematic review). Outcomes were: success of implantation, peri-procedural complications, mortality, and adequate occlusion (complete occlusion or neck remnant). In total (initial review + update), 12 uncontrolled case-series studies were included, reporting outcomes for 940 patients (68.6% female; mean age, 57 years) harboring 962 IAs. Most IAs were wide-neck bifurcation aneurysms (75%-100%), mainly at middle cerebral artery (37%) and anterior communicating artery (24.6%). Feasibility was 97% (95% confidence interval [CI], 95%-99%), and 9% (95%CI, 5%-14%) of cases required additional treatment. There were 14% (95%CI, 9%-19%) peri-procedural complications. After a median clinical follow-up of 7 months, mortality was 5% (95%CI, 1%-10%) and was higher in series with larger proportions of ruptured IAs. At last angiographic follow-up (median, 7 months; range, 3-27.9 months), adequate occlusion rate was 81% (95%CI, 73%-88%). Although WEB showed high rates of adequate aneurysm occlusion at mid-term, procedure-related complications and mortality rates were not negligible. Future studies should compare the WEB device with other treatment options. [Abstract copyright: Copyright © 2018 Elsevier B.V. All rights reserved.]
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RC Internal medicine R Medicine > RD Surgery |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||||
| Library of Congress Subject Headings (LCSH): | Intracranial aneurysms -- Treatment, Blood-vessels -- Endoscopic surgery | ||||||||
| Journal or Publication Title: | Clinical neurology and neurosurgery | ||||||||
| Publisher: | Elsevier | ||||||||
| ISSN: | 0303-8467 | ||||||||
| Official Date: | March 2018 | ||||||||
| Dates: |
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| Date of first compliant deposit: | 23 April 2018 | ||||||||
| Volume: | 166 | ||||||||
| Page Range: | pp. 110-115 | ||||||||
| DOI: | 10.1016/j.clineuro.2018.01.025 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Publisher Statement: | ** From PubMed via Jisc Publications Router. ** History: received 22-12-2017; revised 17-01-2018; accepted 21-01-2018. | ||||||||
| Access rights to Published version: | Restricted or Subscription Access |
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