BackgroundThe Woven Endo-Bridge (WEB) device revolutionized the treatment of wide-necked bifurcation aneurysms by intrasaccular flow diversion. The latest advancement is the WEB-17 system, offering greater flexibility with fewer wires, enabling treatment of smaller distal aneurysms using smaller microcatheters than the WEB-21 system.MethodsWe conducted a systematic review following preferred reporting items for systematic reviews and meta-analyses guidelines, analyzing data from seven retrospective cohort studies involving 483 aneurysms treated with the WEB-17 device. Statistical analysis computed pooled prevalence rates and 95% confidence intervals using appropriate models for each outcome and R software version 4.3.1 (R Foundation for Statistical Computing, Vienna, Austria).ResultsTechnical success was achieved in 475 out of 483 aneurysms treated with the WEB-17 device, with a success rate of 98.34% (95% confidence interval (CI) = 96.72–99.17). Among the successful cases, 4.97% (95% CI = 1.60–14.39) required adjunctive devices. Adequate occlusion, defined as complete occlusion or neck remnants, was observed in 94.41% (95% CI = 88.17–97.46) of cases. Periprocedural complications were infrequent, with thromboembolic complications occurring in 4.93% (95% CI = 3.29–7.30) of cases, hemorrhagic complications in 1.28% (95% CI = 0.58–2.83), and postprocedural neurologic complications in 0.99% (95% CI = 0.31–3.14). Procedure-related morbidity was observed in 1.71% (95% CI = 0.86–3.39) of cases, and there was one procedure-related mortality reported at 0.21% (95% CI = .03–1.50). Mortality unrelated to the procedure occurred in 1% (95% CI = 0.23–4.15).ConclusionOur findings suggest that the WEB-17 device is associated with a high rate of technical success, favorable angiographic outcomes, and a low rate of periprocedural complications. Further research, including prospective trials, is needed to confirm these findings and establish its safety and efficacy definitively.

中文翻译：

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用于颅内动脉瘤治疗的 Woven Endo-Bridge-17 装置的安全性和有效性：系统评价和荟萃分析

背景编织内桥（WEB）装置彻底改变了通过囊内血流转向治疗宽颈分叉动脉瘤的方法。最新的进步是 WEB-17 系统，它以更少的电线提供更大的灵活性，能够使用比 WEB-21 系统更小的微导管治疗更小的远端动脉瘤。方法我们按照系统评价和荟萃分析指南的首选报告项目进行了系统评价，分析了七项回顾性队列研究的数据，涉及 WEB-17 设备治疗的 483 个动脉瘤。统计分析使用每种结果的适当模型和 R 软件版本 4.3.1（R 统计计算基金会，维也纳，奥地利）计算汇总患病率和 95% 置信区间。结果 在 WEB 治疗的 483 个动脉瘤中，有 475 个取得了技术成功-17 设备，成功率为 98.34%（95% 置信区间 (CI) = 96.72–99.17）。在成功的案例中，4.97% (95% CI = 1.60–14.39) 需要辅助装置。94.41% (95% CI = 88.17–97.46) 的病例观察到充分闭塞，定义为完全闭塞或颈部残留。围手术期并发症并不常见，其中血栓栓塞并发症发生率为 4.93% (95% CI = 3.29–7.30)，出血并发症发生率为 1.28% (95% CI = 0.58–2.83)，术后神经系统并发症发生率为 0.99% (95% CI = 0.58–2.83)。 = 0.31–3.14）。1.71% (95% CI = 0.86–3.39) 的病例中观察到与手术相关的发病率，报告称与手术相关的死亡率为 0.21% (95% CI = 0.03–1.50)。与手术无关的死亡率为 1%（95% CI = 0.23–4.15）。结论我们的研究结果表明，WEB-17 装置与高技术成功率、良好的血管造影结果和低围手术期并发症发生率相关。需要进一步的研究，包括前瞻性试验来证实这些发现并明确确定其安全性和有效性。