Background & purpose

The safety and efficacy of the Woven EndoBridge (WEB) device has been proven in recent multicenter trials. This study investigated whether operator experience influences WEB treatment-related outcomes.

Material and methods

This was a retrospective analysis of a prospectively collected multicenter database. The data of all patients who underwent WEB treatment for an intracranial aneurysm from March 2014 to June 2020 in two high-volume centers were pooled. Operator experience was indexed by the number of WEB treatments performed previously. The primary endpoint was the overall complication rate. Secondary endpoints were long-term adequate (Raymond-Roy classification of 1–2.) angiographic occlusion, WEB-related complications, number of WEB not deployed, procedure duration, and radiation exposure (air kerma).

Results

Among 237 patients (mean age 59.4 +/- 11.5 years) treated with WEB (median aneurysm diameter, 5.8 mm; interquartile range 4.5–7 mm), WEB-related complications occurred in 28 patients (11.8%) and adequate long-term occlusion was achieved for 154 aneurysms (86%). The median number of WEB treatment performed previously per operator was 20 (IQR, 9-41). The overall complication rate, WEB-related complication rate and aneurysm occlusion rate were not significantly correlated with WEB operator experience. There were also no significant correlations between the WEB operator experience and the number of WEB not deployed, procedure duration or radiation exposure.

Conclusion

There was no significant association between the number of WEB treatments previously performed per operator and any technical or clinical results after intracranial aneurysm treatment with WEB. These results imply a relatively short learning curve for this device in high-volume neurovascular centers.

中文翻译：

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操作者经验对Woven EndoBridge 血管内治疗颅内动脉瘤技术和临床结果的影响

背景和目的

Woven EndoBridge (WEB) 设备的安全性和有效性已在最近的多中心试验中得到证明。本研究调查了操作者的经验是否会影响 WEB 治疗相关的结果。

材料与方法

这是对前瞻性收集的多中心数据库的回顾性分析。汇总了 2014 年 3 月至 2020 年 6 月在两个高容量中心接受 WEB 治疗颅内动脉瘤的所有患者的数据。操作者的经验是由之前进行的 WEB 治疗的数量来索引的。主要终点是总体并发症发生率。次要终点是长期充分的（Raymond-Roy 分类为 1-2。）血管造影闭塞、WEB 相关并发症、未部署的 WEB 数量、手术持续时间和辐射暴露（空气比释动能）。

结果

在接受 WEB 治疗的 237 名患者（平均年龄 59.4 +/- 11.5 岁）中（中位动脉瘤直径 5.8 mm；四分位距 4.5-7 mm），28 名患者（11.8%）发生了 WEB 相关并发症，并且有足够的长期闭塞154 个动脉瘤 (86%) 达到了这一目标。每个操作员之前进行的 WEB 治疗的中位数为 20 (IQR, 9-41)。总体并发症发生率、WEB相关并发症发生率和动脉瘤闭塞率与WEB操作者经验无显着相关性。WEB 操作员的经验与未部署的 WEB 数量、手术持续时间或辐射暴露之间也没有显着相关性。

结论

每位操作者之前进行的 WEB 治疗次数与使用 WEB 治疗颅内动脉瘤后的任何技术或临床结果之间没有显着关联。这些结果意味着该设备在高容量神经血管中心的学习曲线相对较短。