Incidence and predictors of Woven EndoBridge (WEB) shape modification following treatment of intracranial aneurysms in a large multicenter study
Adeeb, Nimer ; Salim, Hamza Adel ; Musmar, Basel ; Aslan, Assala ; Swaid, Christian ; Cuellar, Miguel ; Dibas, Mahmoud ; Cancelliere, Nicole M ; Diestro, Jose Danilo Bengzon ; Algin, Oktay ... show 10 more
Authors
Salim, Hamza Adel
Musmar, Basel
Aslan, Assala
Swaid, Christian
Cuellar, Miguel
Dibas, Mahmoud
Cancelliere, Nicole M
Diestro, Jose Danilo Bengzon
Algin, Oktay
Ghozy, Sherief
Lay, Sovann V
Guenego, Adrien
Renieri, Leonardo
Carnevale, Joseph
Saliou, Guillaume
Mastorakos, Panagiotis
Naamani, Kareem El
Shotar, Eimad
Möhlenbruch, Markus
Kral, Michael
Chung, Charlotte
Salem, Mohamed M
Lylyk, Ivan
Foreman, Paul M
Shaikh, Hamza
Župančić, Vedran
Hafeez, Muhammad U
Catapano, Joshua
Waqas, Muhammad
Arslan, Muhammet
Ergun, Onur
Rabinov, James D
Ren, Yifan
Schirmer, Clemens M
Piano, Mariangela
Kühn, Anna L
Michelozzi, Caterina
Starke, Robert M
Hassan, Ameer
Ogilvie, Mark
Nguyen, Anh
Jones, Jesse
Brinjikji, Waleed
Nawka, Marie T
Psychogios, Marios
Ulfert, Christian
Pukenas, Bryan
Burkhardt, Jan-Karl
Huynh, Thien
Martinez-Gutierrez, Juan Carlos
Essibayi, Muhammed Amir
Sheth, Sunil A
Slawski, Diana
Tawk, Rabih
Pulli, Benjamin
Lubicz, Boris
Panni, Pietro
Puri, Ajit S
Pero, Guglielmo
Raz, Eytan
Griessenauer, Christoph J
Asadi, Hamed
Siddiqui, Adnan
Levy, Elad I
Haranhalli, Neil
Altschul, David
Ducruet, Andrew F
Albuquerque, Felipe C
Regenhardt, Robert W
Stapleton, Christopher J
Kan, Peter
Kalousek, Vladimir
Lylyk, Pedro
Boddu, Srikanth
Knopman, Jared
Tjoumakaris, Stavropoula I
Jabbour, Pascal M
Clarençon, Frédéric
Limbucci, Nicola
Yedavalli, Vivek
Wintermark, Max
Pereira, Vitor Mendes
Patel, Aman B
Cuellar-Saenz, Hugo H
Dmytriw, Adam A
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Abstract
The Woven EndoBridge (WEB) device is FDA-approved for the treatment of bifurcation aneurysms. Despite its wide popularity, it has been under scrutiny for its association with potential aneurysm recanalization and retreatment due to device shape modification. This study aims to analyze the shape modification rate of WEB devices and identify factors associated with this phenomenon, as well as its correlation with aneurysm retreatment. We conducted a retrospective review of the WorldWide WEB Consortium database, including adult patients treated for intracranial aneurysms with the WEB device. We assessed aneurysm occlusion using the WEB Occlusion Scale and defined WEB shape modification as a percentage reduction in the distance between two WEB markers. Logistic regression and Cox proportional hazards models were utilized to evaluate predictors of shape modification and retreatment. Kaplan-Meier curves were used to estimate the time-dependent probability of no or minor shape modification. A total of 405 patients were analyzed, with minor and major shape modification occurring in 31.4% and 10.1% of cases, respectively. Major shape modification was associated with lower rates of adequate occlusion (70.7%) compared to no or minor shape modification (86.6%) and a higher rate of retreatment (26.8% vs. 8.1%). Predictors of major shape modification included the presence of daughter sac, bifurcation aneurysms, absence of immediate flow stagnation, and a WEB width minus aneurysm width ratio ≤ 0.5. The probability of no or minor shape modification declined within the first 25 months and stabilized thereafter. WEB device shape modification is a significant predictor of aneurysm occlusion efficacy and retreatment. Recognizing the factors influencing shape modification can guide treatment decisions and follow-up protocols to improve patient outcomes.
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Adeeb N, Salim HA, Musmar B, Aslan A, Swaid C, Cuellar M, Dibas M, Cancelliere NM, Diestro JDB, Algin O, Ghozy S, Lay SV, Guenego A, Renieri L, Carnevale J, Saliou G, Mastorakos P, Naamani KE, Shotar E, Möhlenbruch M, Kral M, Chung C, Salem MM, Lylyk I, Foreman PM, Shaikh H, Župančić V, Hafeez MU, Catapano J, Waqas M, Arslan M, Ergun O, Rabinov JD, Ren Y, Schirmer CM, Piano M, Kühn AL, Michelozzi C, Starke RM, Hassan A, Ogilvie M, Nguyen A, Jones J, Brinjikji W, Nawka MT, Psychogios M, Ulfert C, Pukenas B, Burkhardt JK, Huynh T, Martinez-Gutierrez JC, Essibayi MA, Sheth SA, Slawski D, Tawk R, Pulli B, Lubicz B, Panni P, Puri AS, Pero G, Raz E, Griessenauer CJ, Asadi H, Siddiqui A, Levy EI, Haranhalli N, Altschul D, Ducruet AF, Albuquerque FC, Regenhardt RW, Stapleton CJ, Kan P, Kalousek V, Lylyk P, Boddu S, Knopman J, Tjoumakaris SI, Jabbour PM, Clarençon F, Limbucci N, Yedavalli V, Wintermark M, Pereira VM, Patel AB, Cuellar-Saenz HH, Dmytriw AA; Worldwide Web Workgroup. Incidence and predictors of Woven EndoBridge (WEB) shape modification following treatment of intracranial aneurysms in a large multicenter study. Neurosurg Rev. 2025 Feb 25;48(1):265. doi: 10.1007/s10143-025-03344-0. PMID: 39994082; PMCID: PMC11850463.