Background

The concept of intrasaccular flow diversion using the Woven EndoBridge (WEB) device changed the traditional endovascular concept for wide-necked bifurcation aneurysms. The latest technical advancement resulted in the WEB 17 system, a softer device composed of fewer wires which enables treatment of smaller more distally located aneurysms by using smaller microcatheters as compared to the WEB 21 system.

Objective

This retrospective observational study aimed to evaluate and compare the angiographic and clinical results achieved with WEB 21 and WEB 17 in aneurysm morphologies eligible for both systems (maximum width 3–6 mm).

Methods

Between August 2014 and August 2019 a total of 63 and 130 aneurysms with a maximum width of 3–6 mm were treated with either WEB 21 and WEB 17, respectively, at 2 neurovascular centers. Cases were analyzed based on a comparison regarding aneurysm size, location and rupture status.

Results

The technical success, the periprocedural complication rate and the rate of additional devices used showed no relevant differences between the two groups. Aneurysms treated with the WEB 17 system were smaller and more frequently distally located. The overall complete occlusion rate at 3 months was higher in the WEB 17 group (65.5% versus 55.1%). The superiority of complete aneurysm occlusion achieved with WEB 17 was statistically significant in the subgroup of unruptured middle cerebral artery aneurysms.

Conclusion

The use of WEB 17 expands the treatment indications for intrasaccular flow-diversion towards smaller and more distally located aneurysms with a safety profile comparable with that of the WEB 21.

中文翻译：

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使用 WEB 17 与 WEB 21 系统治疗破裂和未破裂的颅内动脉瘤：适应症和早期血管造影结果的比较。

背景

使用 Woven EndoBridge (WEB) 设备的囊内血流分流概念改变了宽颈分叉动脉瘤的传统血管内概念。最新的技术进步催生了 WEB 17 系统，这是一种由更少导线组成的更柔软的设备，与 WEB 21 系统相比，它能够通过使用更小的微导管来治疗更小、更远的动脉瘤。

客观的

这项回顾性观察研究旨在评估和比较 WEB 21 和 WEB 17 在适合两种系统（最大宽度 3-6 毫米）的动脉瘤形态方面取得的血管造影和临床结果。

方法

2014 年 8 月至 2019 年 8 月期间，在 2 个神经血管中心分别用 WEB 21 和 WEB 17 治疗了 63 和 130 个最大宽度为 3-6 毫米的动脉瘤。基于动脉瘤大小、位置和破裂状态的比较分析病例。

结果

技术成功率、围手术期并发症发生率和使用额外装置的比率显示两组之间没有相关差异。用 WEB 17 系统治疗的动脉瘤更小，更常位于远端。WEB 17 组在 3 个月时的整体完全闭塞率更高（65.5% 对 55.1%）。在未破裂大脑中动脉动脉瘤亚组中，WEB 17 实现的完全动脉瘤闭塞的优越性具有统计学意义。

结论

WEB 17 的使用扩大了囊内血流分流的治疗适应症，适用于更小、更远端的动脉瘤，其安全性与 WEB 21 相当。