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<meta name="DC.Title" content="Efficacy and Safety of the Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4900" />
<meta name="DC.Date" content="2016-12-01" />
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<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Intrasaccular flow diverters are increasingly being used in the treatment of wide-neck and bifurcation aneurysms. We performed a systematic review and meta-analysis of existing literature on the Woven EndoBridge device in the treatment of intracranial aneurysms.

MATERIALS AND METHODS: A comprehensive literature search was performed through October 1, 2015. We extracted information on baseline aneurysm and patient characteristics. Outcomes studied included immediate and midterm (&gt;3 month) angiographic outcomes (complete occlusion as well as adequate occlusion, defined as complete occlusion or neck remnant), aneurysm retreatment, intraoperative rupture, perioperative morbidity and mortality, thromboembolic complications, and treatment failure. Meta-analysis was performed by using the random-effects model.

RESULTS: Fifteen uncontrolled series were included in this analysis, including 565 patients with 588 aneurysms, of which 127 were ruptured. Initial complete and adequate occlusion rates were 27% (95% CI, 15%–39%) and 59% (95% CI, 39%–78%), respectively. Midterm complete and adequate occlusion rates after a median of 7 months were 39% (95% CI, 26%–52%) and 85% (95% CI, 78%–91%), respectively. Perioperative morbidity and mortality rates were 4% (95% CI, 1%–8%) and 1% (95% CI, 0%–2%), respectively. Midterm adequate occlusion rates for ruptured aneurysms were 85% (95% CI, 67%–98%), compared with 84% (95% CI, 72%–94%) for unruptured aneurysms ( P = .89). Patients with ruptured aneurysm had similar rates of perioperative morbidity to patients with unruptured aneurysm (2%; 95% CI, 0%–26% versus 2%; 95% CI, 0%–6%, respectively; P = .35).

CONCLUSIONS: Early evidence derived from uncontrolled studies suggests that Woven EndoBridge treatment has a good safety profile and promising rates of adequate occlusion, especially given the complexity of aneurysms treated. Further prospective clinical trials are needed to confirm these results and better define the risks and benefits of use of the Woven EndoBridge device in treating wide-neck and wide-neck bifurcation aneurysms.

WEB
:   Woven EndoBridge" />
<meta name="DC.Contributor" content="S. Asnafi" />
<meta name="DC.Contributor" content="A. Rouchaud" />
<meta name="DC.Contributor" content="L. Pierot" />
<meta name="DC.Contributor" content="W. Brinjikji" />
<meta name="DC.Contributor" content="M.H. Murad" />
<meta name="DC.Contributor" content="D.F. Kallmes" />
<meta name="article:published_time" content="2016-12-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Efficacy and Safety of the Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Intrasaccular flow diverters are increasingly being used in the treatment of wide-neck and bifurcation aneurysms. We performed a systematic review and meta-analysis of existing literature on the Woven EndoBridge device in the treatment of intracranial aneurysms.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A comprehensive literature search was performed through October 1, 2015. We extracted information on baseline aneurysm and patient characteristics. Outcomes studied included immediate and midterm (&amp;gt;3 month) angiographic outcomes (complete occlusion as well as adequate occlusion, defined as complete occlusion or neck remnant), aneurysm retreatment, intraoperative rupture, perioperative morbidity and mortality, thromboembolic complications, and treatment failure. Meta-analysis was performed by using the random-effects model.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Fifteen uncontrolled series were included in this analysis, including 565 patients with 588 aneurysms, of which 127 were ruptured. Initial complete and adequate occlusion rates were 27% (95% CI, 15%–39%) and 59% (95% CI, 39%–78%), respectively. Midterm complete and adequate occlusion rates after a median of 7 months were 39% (95% CI, 26%–52%) and 85% (95% CI, 78%–91%), respectively. Perioperative morbidity and mortality rates were 4% (95% CI, 1%–8%) and 1% (95% CI, 0%–2%), respectively. Midterm adequate occlusion rates for ruptured aneurysms were 85% (95% CI, 67%–98%), compared with 84% (95% CI, 72%–94%) for unruptured aneurysms (&lt;i&gt;P&lt;/i&gt; = .89). Patients with ruptured aneurysm had similar rates of perioperative morbidity to patients with unruptured aneurysm (2%; 95% CI, 0%–26% versus 2%; 95% CI, 0%–6%, respectively; &lt;i&gt;P&lt;/i&gt; = .35).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Early evidence derived from uncontrolled studies suggests that Woven EndoBridge treatment has a good safety profile and promising rates of adequate occlusion, especially given the complexity of aneurysms treated. Further prospective clinical trials are needed to confirm these results and better define the risks and benefits of use of the Woven EndoBridge device in treating wide-neck and wide-neck bifurcation aneurysms.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2016/12/01" />
<meta name="citation_mjid" content="ajnr;37/12/2287" />
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<meta name="citation_issn" content="0195-6108" />
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<meta name="citation_doi" content="10.3174/ajnr.A4900" />
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<meta name="citation_volume" content="37" />
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<meta name="citation_firstpage" content="2287" />
<meta name="citation_lastpage" content="2292" />
<meta name="citation_author" content="S. Asnafi" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology (S.A., A.R., W.B., D.F.K.)" />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0003-4059-167X" />
<meta name="citation_author" content="A. Rouchaud" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology (S.A., A.R., W.B., D.F.K.)" />
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<meta name="citation_author" content="L. Pierot" />
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<meta name="citation_author" content="M.H. Murad" />
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<meta name="twitter:title" content="Efficacy and Safety of the Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Intrasaccular flow diverters are increasingly being used in the treatment of wide-neck and bifurcation aneurysms. We performed a systematic review and meta-analysis of existing literature on the Woven EndoBridge device in the treatment of intracranial aneurysms.

MATERIALS AND METHODS: A comprehensive literature search was performed through October 1, 2015. We extracted information on baseline aneurysm and patient characteristics. Outcomes studied included immediate and midterm (&gt;3 month) angiographic outcomes (complete occlusion as well as adequate occlusion, defined as complete occlusion or neck remnant), aneurysm retreatment, intraoperative rupture, perioperative morbidity and mortality, thromboembolic complications, and treatment failure. Meta-analysis was performed by using the random-effects model.

RESULTS: Fifteen uncontrolled series were included in this analysis, including 565 patients with 588 aneurysms, of which 127 were ruptured. Initial complete and adequate occlusion rates were 27% (95% CI, 15%–39%) and 59% (95% CI, 39%–78%), respectively. Midterm complete and adequate occlusion rates after a median of 7 months were 39% (95% CI, 26%–52%) and 85% (95% CI, 78%–91%), respectively. Perioperative morbidity and mortality rates were 4% (95% CI, 1%–8%) and 1% (95% CI, 0%–2%), respectively. Midterm adequate occlusion rates for ruptured aneurysms were 85% (95% CI, 67%–98%), compared with 84% (95% CI, 72%–94%) for unruptured aneurysms ( P = .89). Patients with ruptured aneurysm had similar rates of perioperative morbidity to patients with unruptured aneurysm (2%; 95% CI, 0%–26% versus 2%; 95% CI, 0%–6%, respectively; P = .35).

CONCLUSIONS: Early evidence derived from uncontrolled studies suggests that Woven EndoBridge treatment has a good safety profile and promising rates of adequate occlusion, especially given the complexity of aneurysms treated. Further prospective clinical trials are needed to confirm these results and better define the risks and benefits of use of the Woven EndoBridge device in treating wide-neck and wide-neck bifurcation aneurysms.

WEB
:   Woven EndoBridge" />
<meta name="og-title" property="og:title" content="Efficacy and Safety of the Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/37/12/2287" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Intrasaccular flow diverters are increasingly being used in the treatment of wide-neck and bifurcation aneurysms. We performed a systematic review and meta-analysis of existing literature on the Woven EndoBridge device in the treatment of intracranial aneurysms.

MATERIALS AND METHODS: A comprehensive literature search was performed through October 1, 2015. We extracted information on baseline aneurysm and patient characteristics. Outcomes studied included immediate and midterm (&gt;3 month) angiographic outcomes (complete occlusion as well as adequate occlusion, defined as complete occlusion or neck remnant), aneurysm retreatment, intraoperative rupture, perioperative morbidity and mortality, thromboembolic complications, and treatment failure. Meta-analysis was performed by using the random-effects model.

RESULTS: Fifteen uncontrolled series were included in this analysis, including 565 patients with 588 aneurysms, of which 127 were ruptured. Initial complete and adequate occlusion rates were 27% (95% CI, 15%–39%) and 59% (95% CI, 39%–78%), respectively. Midterm complete and adequate occlusion rates after a median of 7 months were 39% (95% CI, 26%–52%) and 85% (95% CI, 78%–91%), respectively. Perioperative morbidity and mortality rates were 4% (95% CI, 1%–8%) and 1% (95% CI, 0%–2%), respectively. Midterm adequate occlusion rates for ruptured aneurysms were 85% (95% CI, 67%–98%), compared with 84% (95% CI, 72%–94%) for unruptured aneurysms ( P = .89). Patients with ruptured aneurysm had similar rates of perioperative morbidity to patients with unruptured aneurysm (2%; 95% CI, 0%–26% versus 2%; 95% CI, 0%–6%, respectively; P = .35).

CONCLUSIONS: Early evidence derived from uncontrolled studies suggests that Woven EndoBridge treatment has a good safety profile and promising rates of adequate occlusion, especially given the complexity of aneurysms treated. Further prospective clinical trials are needed to confirm these results and better define the risks and benefits of use of the Woven EndoBridge device in treating wide-neck and wide-neck bifurcation aneurysms.

WEB
:   Woven EndoBridge" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node104--5" data-node-nid="104" id="top-node-104--62018817722" data-pisa="ajnr;37/12/2287" data-pisa-master="ajnr;ajnr.A4900" data-apath="/ajnr/37/12/2287.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Efficacy and Safety of the Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S. Asnafi</span>, <span class="highwire-citation-author" data-delta="1">A. Rouchaud</span>, <span class="highwire-citation-author" data-delta="2">L. Pierot</span>, <span class="highwire-citation-author" data-delta="3">W. Brinjikji</span>, <span class="highwire-citation-author" data-delta="4">M.H. Murad</span> and <span class="highwire-citation-author" data-delta="5">D.F. Kallmes</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">December 2016,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2287-2292; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4900 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-104--62018817722" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S. Asnafi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (S.A., A.R., W.B., D.F.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BAsnafi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Asnafi%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.%2BAsnafi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-4059-167X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Asnafi</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A. Rouchaud </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (S.A., A.R., W.B., D.F.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BRouchaud%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rouchaud%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BRouchaud%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0902-3375" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Rouchaud</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">L. Pierot </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Neuroradiology (L.P.), Maison Blanche Hospital, University of Reims Champagne-Ardenne, Reims, France.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BPierot%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pierot%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BPierot%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-2523-4909" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Pierot</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">W. Brinjikji </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (S.A., A.R., W.B., D.F.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.%2BBrinjikji%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Brinjikji%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AW.%2BBrinjikji%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5271-5524" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for W. Brinjikji</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">M.H. Murad </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Center for the Science of Healthcare Delivery (M.H.M.), Mayo Clinic, Rochester, Minnesota</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.H.%2BMurad%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Murad%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.H.%2BMurad%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5502-5975" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.H. Murad</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">D.F. Kallmes </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (S.A., A.R., W.B., D.F.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.F.%2BKallmes%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kallmes%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.F.%2BKallmes%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-8495-0040" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.F. Kallmes</a></li></ul></div></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 37</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 12 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Dec 2016 </div></div>
      
      
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Dec 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2287-2292; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4900 </span></div>
  
  
  
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      <div class="highwire-cite-title">Efficacy and Safety of the Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Asnafi</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Rouchaud</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Pierot</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">W.</span> <span class="nlm-surname">Brinjikji</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.H.</span> <span class="nlm-surname">Murad</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.F.</span> <span class="nlm-surname">Kallmes</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Dec 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2287-2292; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4900 </span></div>
  
  
  
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