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<meta name="DC.Title" content="Endovascular Treatment of Intracranial Aneurysms with the WEB Device: A Systematic Review of Clinical Outcomes" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4611" />
<meta name="DC.Date" content="2015-11-19" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Despite the improvement in technology, endovascular treatment of bifurcation intracranial wide-neck aneurysms remains challenging, mainly due to the difficulty of maintaining coils within the aneurysm sac without compromising the patency of bifurcation arteries. The Woven EndoBridge (WEB) device is a recent intrasaccular braided device specifically dedicated to treating such aneurysms with a wide neck by disrupting the flow in the aneurysmal neck and promoting progressive aneurysmal thrombosis.

MATERIALS AND METHODS: Using several health data bases, we conducted a systematic review of all published studies of WEB endovascular treatment in intracranial aneurysms from 2010 onward to evaluate its efficacy and safety profile.

RESULTS: The literature search identified 6 relevant studies (7 articles) including wide-neck bifurcation aneurysms in ≥80% of cases. Clinical data supporting the efficacy and safety of the WEB are limited to noncomparative cohort studies with large heterogeneity from a methodologic standpoint. The WEB deployment was feasible with a success rate of 93%-100%. Permanent morbidity (mRS of &gt;1 at last follow-up) and mortality were measured at 2.2%-6.7% and 0%-17%, respectively. The adequate occlusion rate (total occlusion or neck remnant) varied between 65% and 85.4% at midterm follow-up (range, 3.3-27.4 months).

CONCLUSIONS: Endovascular treatment of bifurcation wide-neck aneurysms with the WEB device is feasible and allows an acceptably adequate aneurysm occlusion rate; however, the rate of neck remnants is not negligible. The WEB device needs further clinical and anatomic evaluation with long-term prospective studies, especially of the risk of WEB compression. Prospective controlled studies should be encouraged.

### Abbreviations

CE
:   Conformité Européenne
PRISMA
:   Preferred Reporting Items for Systematic Reviews and Meta-Analyses
WEB
:   Woven EndoBridge
WEB-DL
:   Woven EndoBridge Dual-Layer
WEB-SL
:   Woven EndoBridge Single-Layer
WEB-SLS
:   Woven EndoBridge Single-Layer Sphere" />
<meta name="DC.Contributor" content="X. Armoiry" />
<meta name="DC.Contributor" content="F. Turjman" />
<meta name="DC.Contributor" content="D.J. Hartmann" />
<meta name="DC.Contributor" content="R. Sivan-Hoffmann" />
<meta name="DC.Contributor" content="R. Riva" />
<meta name="DC.Contributor" content="P.E. Labeyrie" />
<meta name="DC.Contributor" content="G. Aulagner" />
<meta name="DC.Contributor" content="B. Gory" />
<meta name="article:published_time" content="2015-11-19" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="Endovascular Treatment of Intracranial Aneurysms with the WEB Device: A Systematic Review of Clinical Outcomes" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Despite the improvement in technology, endovascular treatment of bifurcation intracranial wide-neck aneurysms remains challenging, mainly due to the difficulty of maintaining coils within the aneurysm sac without compromising the patency of bifurcation arteries. The Woven EndoBridge (WEB) device is a recent intrasaccular braided device specifically dedicated to treating such aneurysms with a wide neck by disrupting the flow in the aneurysmal neck and promoting progressive aneurysmal thrombosis.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Using several health data bases, we conducted a systematic review of all published studies of WEB endovascular treatment in intracranial aneurysms from 2010 onward to evaluate its efficacy and safety profile.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The literature search identified 6 relevant studies (7 articles) including wide-neck bifurcation aneurysms in ≥80% of cases. Clinical data supporting the efficacy and safety of the WEB are limited to noncomparative cohort studies with large heterogeneity from a methodologic standpoint. The WEB deployment was feasible with a success rate of 93%-100%. Permanent morbidity (mRS of &amp;gt;1 at last follow-up) and mortality were measured at 2.2%-6.7% and 0%-17%, respectively. The adequate occlusion rate (total occlusion or neck remnant) varied between 65% and 85.4% at midterm follow-up (range, 3.3-27.4 months).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Endovascular treatment of bifurcation wide-neck aneurysms with the WEB device is feasible and allows an acceptably adequate aneurysm occlusion rate; however, the rate of neck remnants is not negligible. The WEB device needs further clinical and anatomic evaluation with long-term prospective studies, especially of the risk of WEB compression. Prospective controlled studies should be encouraged.&lt;/p&gt;" />
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<meta name="citation_publication_date" content="2015/11/19" />
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<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="INTERVENTIONAL" />
<meta name="citation_author" content="X. Armoiry" />
<meta name="citation_author_institution" content="From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France." />
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<meta name="citation_author_institution" content="From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France." />
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<meta name="citation_author_institution" content="From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-1829-4102" />
<meta name="citation_author" content="R. Sivan-Hoffmann" />
<meta name="citation_author_institution" content="From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-3757-7298" />
<meta name="citation_author" content="R. Riva" />
<meta name="citation_author_institution" content="From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-1520-2057" />
<meta name="citation_author" content="P.E. Labeyrie" />
<meta name="citation_author_institution" content="From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-2536-6338" />
<meta name="citation_author" content="G. Aulagner" />
<meta name="citation_author_institution" content="From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-0729-9549" />
<meta name="citation_author" content="B. Gory" />
<meta name="citation_author_institution" content="From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0001-8424-4464" />
<meta name="twitter:title" content="Endovascular Treatment of Intracranial Aneurysms with the WEB Device: A Systematic Review of Clinical Outcomes" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Despite the improvement in technology, endovascular treatment of bifurcation intracranial wide-neck aneurysms remains challenging, mainly due to the difficulty of maintaining coils within the aneurysm sac without compromising the patency of bifurcation arteries. The Woven EndoBridge (WEB) device is a recent intrasaccular braided device specifically dedicated to treating such aneurysms with a wide neck by disrupting the flow in the aneurysmal neck and promoting progressive aneurysmal thrombosis.

MATERIALS AND METHODS: Using several health data bases, we conducted a systematic review of all published studies of WEB endovascular treatment in intracranial aneurysms from 2010 onward to evaluate its efficacy and safety profile.

RESULTS: The literature search identified 6 relevant studies (7 articles) including wide-neck bifurcation aneurysms in ≥80% of cases. Clinical data supporting the efficacy and safety of the WEB are limited to noncomparative cohort studies with large heterogeneity from a methodologic standpoint. The WEB deployment was feasible with a success rate of 93%-100%. Permanent morbidity (mRS of &gt;1 at last follow-up) and mortality were measured at 2.2%-6.7% and 0%-17%, respectively. The adequate occlusion rate (total occlusion or neck remnant) varied between 65% and 85.4% at midterm follow-up (range, 3.3-27.4 months).

CONCLUSIONS: Endovascular treatment of bifurcation wide-neck aneurysms with the WEB device is feasible and allows an acceptably adequate aneurysm occlusion rate; however, the rate of neck remnants is not negligible. The WEB device needs further clinical and anatomic evaluation with long-term prospective studies, especially of the risk of WEB compression. Prospective controlled studies should be encouraged.

### Abbreviations

CE
:   Conformité Européenne
PRISMA
:   Preferred Reporting Items for Systematic Reviews and Meta-Analyses
WEB
:   Woven EndoBridge
WEB-DL
:   Woven EndoBridge Dual-Layer
WEB-SL
:   Woven EndoBridge Single-Layer
WEB-SLS
:   Woven EndoBridge Single-Layer Sphere" />
<meta name="og-title" property="og:title" content="Endovascular Treatment of Intracranial Aneurysms with the WEB Device: A Systematic Review of Clinical Outcomes" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2015/11/19/ajnr.A4611" />
<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: Despite the improvement in technology, endovascular treatment of bifurcation intracranial wide-neck aneurysms remains challenging, mainly due to the difficulty of maintaining coils within the aneurysm sac without compromising the patency of bifurcation arteries. The Woven EndoBridge (WEB) device is a recent intrasaccular braided device specifically dedicated to treating such aneurysms with a wide neck by disrupting the flow in the aneurysmal neck and promoting progressive aneurysmal thrombosis.

MATERIALS AND METHODS: Using several health data bases, we conducted a systematic review of all published studies of WEB endovascular treatment in intracranial aneurysms from 2010 onward to evaluate its efficacy and safety profile.

RESULTS: The literature search identified 6 relevant studies (7 articles) including wide-neck bifurcation aneurysms in ≥80% of cases. Clinical data supporting the efficacy and safety of the WEB are limited to noncomparative cohort studies with large heterogeneity from a methodologic standpoint. The WEB deployment was feasible with a success rate of 93%-100%. Permanent morbidity (mRS of &gt;1 at last follow-up) and mortality were measured at 2.2%-6.7% and 0%-17%, respectively. The adequate occlusion rate (total occlusion or neck remnant) varied between 65% and 85.4% at midterm follow-up (range, 3.3-27.4 months).

CONCLUSIONS: Endovascular treatment of bifurcation wide-neck aneurysms with the WEB device is feasible and allows an acceptably adequate aneurysm occlusion rate; however, the rate of neck remnants is not negligible. The WEB device needs further clinical and anatomic evaluation with long-term prospective studies, especially of the risk of WEB compression. Prospective controlled studies should be encouraged.

### Abbreviations

CE
:   Conformité Européenne
PRISMA
:   Preferred Reporting Items for Systematic Reviews and Meta-Analyses
WEB
:   Woven EndoBridge
WEB-DL
:   Woven EndoBridge Dual-Layer
WEB-SL
:   Woven EndoBridge Single-Layer
WEB-SLS
:   Woven EndoBridge Single-Layer Sphere" />
<meta name="og-type" property="og:type" content="article" />
<meta name="og-image" property="og:image" content="" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node51432--5" data-node-nid="51432" id="top-node-51432--6372200720" data-pisa="ajnr;ajnr.A4611v1" data-pisa-master="ajnr;ajnr.A4611" data-apath="/ajnr/early/2015/11/19/ajnr.A4611.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">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">INTERVENTIONAL</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Endovascular Treatment of Intracranial Aneurysms with the WEB Device: A Systematic Review of Clinical Outcomes</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">X. Armoiry</span>, <span class="highwire-citation-author" data-delta="1">F. Turjman</span>, <span class="highwire-citation-author" data-delta="2">D.J. Hartmann</span>, <span class="highwire-citation-author" data-delta="3">R. Sivan-Hoffmann</span>, <span class="highwire-citation-author" data-delta="4">R. Riva</span>, <span class="highwire-citation-author" data-delta="5">P.E. Labeyrie</span>, <span class="highwire-citation-author" data-delta="6">G. Aulagner</span> and <span class="highwire-citation-author" data-delta="7">B. Gory</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">November 2015,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4611 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-51432--6372200720" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">X. Armoiry </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, 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=X.%2BArmoiry%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=Armoiry%20X&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%3AX.%2BArmoiry%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/0000-0002-2145-6723" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X. Armoiry</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">F. Turjman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, 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=F.%2BTurjman%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=Turjman%20F&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%3AF.%2BTurjman%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/0000-0001-5006-2320" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F. Turjman</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">D.J. Hartmann </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, 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=D.J.%2BHartmann%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=Hartmann%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.J.%2BHartmann%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/0000-0002-1829-4102" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.J. Hartmann</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">R. Sivan-Hoffmann </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, 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=R.%2BSivan-Hoffmann%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=Sivan-Hoffmann%20R&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%3AR.%2BSivan-Hoffmann%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/0000-0002-3757-7298" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Sivan-Hoffmann</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">R. Riva </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, 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=R.%2BRiva%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=Riva%20R&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%3AR.%2BRiva%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/0000-0002-1520-2057" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Riva</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">P.E. Labeyrie </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, 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=P.E.%2BLabeyrie%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=Labeyrie%20P&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%3AP.E.%2BLabeyrie%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/0000-0002-2536-6338" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.E. Labeyrie</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">G. Aulagner </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, 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=G.%2BAulagner%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=Aulagner%20G&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%3AG.%2BAulagner%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/0000-0002-0729-9549" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G. Aulagner</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">B. Gory </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Délégation à la Recherche Clinique et à l'Innovation (X.A.), Hospices Civils de Lyon, Cellule Innovation, Lyon, France; CNRS 5510/MATEIS (X.A., D.J.H., P.E.L., G.A.), Lyon, France; Service de Neuroradiologie Interventionnelle (F.T., R.S-H., R.R., B.G.), DHU IRIS, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université Lyon 1 (F.T., D.J.H., G.A., B.G.), Lyon, France; Centre de Neurosciences Cognitives (F.T., B.G.), CNRS, UMR 5229, Lyon, France; Galilee Medical Center (R.S.-H.), Nahariya, Israel; Serine Proteases and Pathophysiology of the Neurovascular Unit (P.E.L.), INSERM UMR-S U919, Caen, France; and Service Pharmaceutique (G.A.), Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, 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=B.%2BGory%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=Gory%20B&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%3AB.%2BGory%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/0000-0001-8424-4464" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B. 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    <div class="item-list"><ul class="tabs inline panels-ajax-tab"><li class="first"><a href="/content/early/2015/11/19/ajnr.A4611" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_art" data-target-id="highwire_article_tabs" data-entity-context="node:51432" data-trigger="" data-url-enabled="1">Article</a><a href="/panels_ajax_tab/jnl_ajnr_tab_art/node:51432/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li><a href="/content/early/2015/11/19/ajnr.A4611/tab-supplemental" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_supp" data-target-id="highwire_article_tabs" data-entity-context="node:51432" data-trigger="tab-supplemental" data-url-enabled="1">Supplemental</a><a href="/panels_ajax_tab/jnl_ajnr_tab_supp/node:51432/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li><a href="/content/early/2015/11/19/ajnr.A4611/tab-article-info" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_info" data-target-id="highwire_article_tabs" data-entity-context="node:51432" data-trigger="tab-article-info" data-url-enabled="1">Info &amp; Metrics</a><a href="/panels_ajax_tab/jnl_ajnr_tab_info/node:51432/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li class="last"><a href="/content/ajnr/early/2015/11/19/ajnr.A4611.full.pdf" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_pdf" data-target-id="highwire_article_tabs" data-entity-context="node:51432" data-trigger="tab-pdf" data-url-enabled="1"><i class="icon-file-alt"></i> PDF</a><a href="/panels_ajax_tab/jnl_ajnr_tab_pdf/node:51432/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li></ul></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Despite the improvement in technology, endovascular treatment of bifurcation intracranial wide-neck aneurysms remains challenging, mainly due to the difficulty of maintaining coils within the aneurysm sac without compromising the patency of bifurcation arteries. The Woven EndoBridge (WEB) device is a recent intrasaccular braided device specifically dedicated to treating such aneurysms with a wide neck by disrupting the flow in the aneurysmal neck and promoting progressive aneurysmal thrombosis.</p></div><div id="sec-2" class="subsection"><p id="p-2"><strong>MATERIALS AND METHODS:</strong> Using several health data bases, we conducted a systematic review of all published studies of WEB endovascular treatment in intracranial aneurysms from 2010 onward to evaluate its efficacy and safety profile.</p></div><div id="sec-3" class="subsection"><p id="p-3"><strong>RESULTS:</strong> The literature search identified 6 relevant studies (7 articles) including wide-neck bifurcation aneurysms in ≥80% of cases. Clinical data supporting the efficacy and safety of the WEB are limited to noncomparative cohort studies with large heterogeneity from a methodologic standpoint. The WEB deployment was feasible with a success rate of 93%-100%. Permanent morbidity (mRS of &gt;1 at last follow-up) and mortality were measured at 2.2%-6.7% and 0%-17%, respectively. The adequate occlusion rate (total occlusion or neck remnant) varied between 65% and 85.4% at midterm follow-up (range, 3.3-27.4 months).</p></div><div id="sec-4" class="subsection"><p id="p-4"><strong>CONCLUSIONS:</strong> Endovascular treatment of bifurcation wide-neck aneurysms with the WEB device is feasible and allows an acceptably adequate aneurysm occlusion rate; however, the rate of neck remnants is not negligible. The WEB device needs further clinical and anatomic evaluation with long-term prospective studies, especially of the risk of WEB compression. Prospective controlled studies should be encouraged.</p></div></div><div class="section glossary" id="glossary-1"><h3>Abbreviations</h3><dl id="def-list-1"><dt id="def-item-1">CE<span class="def-item-dt-sep"></span></dt><dd>Conformité Européenne<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">PRISMA<span class="def-item-dt-sep"></span></dt><dd>Preferred Reporting Items for Systematic Reviews and Meta-Analyses<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">WEB<span class="def-item-dt-sep"></span></dt><dd>Woven EndoBridge<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">WEB-DL<span class="def-item-dt-sep"></span></dt><dd>Woven EndoBridge Dual-Layer<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">WEB-SL<span class="def-item-dt-sep"></span></dt><dd>Woven EndoBridge Single-Layer<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">WEB-SLS<span class="def-item-dt-sep"></span></dt><dd>Woven EndoBridge Single-Layer Sphere</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2016 American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></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">Nov 2015, </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4611 </span></div>
  
  
  
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      <div class="highwire-cite-title">Endovascular Treatment of Intracranial Aneurysms with the WEB Device: A Systematic Review of Clinical Outcomes</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">X.</span> <span class="nlm-surname">Armoiry</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Turjman</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">D.J.</span> <span class="nlm-surname">Hartmann</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Sivan-Hoffmann</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Riva</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">P.E.</span> <span class="nlm-surname">Labeyrie</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Aulagner</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Gory</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">Nov 2015, </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4611 </span></div>
  
  
  
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