Abstract Details

Title The Woven EndoBridge (WEB) device for the treatment of Intracranial Aneurysms: A Decade of Lessons Learned and Changes in Practice from the WorldwideWEB Consortium

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 078

Objective

This is a multicenter study of real-world data that attempted to explore the changes in trends and treatment outcomes over time for Woven EndoBridge (WEB) embolization of intracranial aneurysms and to further evaluate for mechanisms and co-variates that could potentially explain that.

Background

Several studies have shown promising outcomes of the WEB for the treatment of wide-neck intracranial bifurcation aneurysms.

Design/Methods

The WorldWideWEB consortium is a retrospective multicenter collaboration of data from international centers spanning from January 2011 and June 2021, with no limitations on aneurysm location or rupture status. Both bifurcation and sidewall aneurysms were included. Then, these patients were stratified based on the treatment year to five treatment intervals: 2011-2015 (N=66), 2016-2017 (N=77), 2018 (N=66), 2019 (N=300), and 2020-2021 (N=173). Patient characteristics, angiographic and clinical outcomes were compared between these time intervals, and we sought to evaluate for determinants of adequate aneurysm occlusion (i.e. complete occlusion or neck remnant).

Results

This study involved 671 patients (median age 61.4 years; 71.2% female) with 683 intracranial aneurysms. Over time, we observed an increasing tendency to treat patients presenting with ruptured aneurysms and aneurysms with smaller neck, diameter, and dome width (p<0.05). Furthermore, we observed a trend towards more off-label use of the WEB for sidewall aneurysms and increased adoption of the transradial access for WEB deployment (p<0.05). Moreover, there was a significant trend towards more attainment of adequate WEB occlusion on last follow-up, and lower rates of compaction and retreatment (p<0.05). Mortality and complications did not differ over time. Immediate remnant aneurysm, and minor compaction or major compaction were significantly associated with lower rates of adequate aneurysm occlusion on last follow-up.

Conclusions

This learning curve has shown improved experience with the usage of the WEB for the treatment of intracranial aneurysms with higher rates of adequate occlusion and lower rates of compaction and retreatment.

Authors/Disclosures
Mahmoud Dibas, MD PRESENTER	Mr. Dibas has nothing to disclose.
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Jose Danilo B. Diestro, MD (St. Michael's Hospital, University of Toronto)	Dr. Diestro has nothing to disclose.
Hugo Cuellar-Saenz	No disclosure on file
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Robert W. Regenhardt, MD, PhD	Dr. Regenhardt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genomadix. Dr. Regenhardt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Rapid Medical. Dr. Regenhardt has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Johnson and Bell Trial Lawyers. Dr. Regenhardt has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Buckley, Theroux, Kline, & Cooley Trial Lawyers. The institution of Dr. Regenhardt has received research support from National Institutes of Health. The institution of Dr. Regenhardt has received research support from Society of Vascular and Interventional Neurology. The institution of Dr. Regenhardt has received research support from Heitman Foundation.
Justin Vranic (Massachusetts General Hospital)	No disclosure on file
Ivan Lylyk	No disclosure on file
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Muhammad Ubaid Hafeez, MD (University of Texas Medical Branch)	Dr. Hafeez has nothing to disclose.
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James Rabinov	James Rabinov has nothing to disclose.
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Anna Luisa Kühn (UMass Memorial Medical Center)	No disclosure on file
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Robert Starke	Robert Starke has nothing to disclose.
Ameer Hassan, DO (Valley Baptist Medical Center)	Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Penumbra. Dr. Hassan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cerenovus. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Viz.ai. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Hassan has received research support from GE Healthcare.
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Ajit Puri	No disclosure on file
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Christopher Stapleton (Massachusetts General Hospital)	Christopher Stapleton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Johnson & Johnson MedTech. Christopher Stapleton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll Circulation, Inc.. Christopher Stapleton has received publishing royalties from a publication relating to health care.
Adnan Siddiqui	Adnan Siddiqui has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott Laboratories, Acandis, Asahi Intecc Co. Ltd., Canon Medical Systems USA, Inc., Carotix Medical, LLC, CerebrovaKP, Cerenovus, Contego Medical, Inc., Cordis, Endostream Medical, Ltd (recently sold to Kaneka), FreeOx Biotech, SL, Hyperfine Operations, Inc., Imperative Care , InspireMD, Ltd., IRRAS AB, Medtronic, Minnetronix Neuro, Inc., MMI, Peijia Medical, Penumbra, Inc. Perflow Medical, Ltd., Piraeus Medical, Inc., Prometheus Therapeutics, Inc., Q'Apel Medical, Inc., Serenity Medical, Inc., Shockwave Medical, Inc., Stryker Neurovascular., Synchron Australia Pty Ltd., Tegus Medical, GmbH, T.G. Medical, Inc., Terumo Neuro (Formerly MicroVention), Unity Medical, Inc. Vastrax, LLC, Vesalio, Viz.ai, Inc., WL Gore. Adnan Siddiqui has stock in 3N Endovascular, Adona Medical, Inc., Basecamp Vascular SAS, Bend IT Technologies, Ltd., BlinkTBI, Inc, Borvo Medical, Inc., CerebrovaKP, Code Zero Medical, Inc., Cognition Medical, Collavidence, Inc., Contego Medical, Inc., CVAID Ltd., CygnusMed, E8, Inc., Endostream Medical, Ltd (Sold 2025 to Kaneka), FreeOx Biotech, SL, Galaxy Therapeutics, Inc., Hyperion Surgical, Inc., Imperative Care, Inc., InspireMD, Ltd., Instylla, Inc., IRRAS, AB, Launch NY, Inc., Neurolutions, Inc., Neurovascular Diagnostics, Inc., NeXtGen Biologics, Peijia Medical, PerFlow Medical, Ltd., Physician X, LLC, Piraeus Medical, Inc., Prometheus Therapeutics, Inc., PUMA Venture Capital Fund I, LP, Q'Apel Medical, Inc., QAS.ai, Inc., Radical Catheter Technologies, Inc., ReNiva, Inc., Rist Neurovascular, Inc. (Purchased 2020 by Medtronic), Sense Diagnostics, Inc., Serenity Medical, Inc., Silk Road Medical, Sim & Cure, Spinnaker Medical, Inc., Stent'Up, Synchron, Inc., Tegus Medical, GmbH, T.G. Medical, Inc., Tulavi Therapeutics, Inc., Vastrax, LLC,, Viseon, Inc., Viz.ai, Whisper Medical, Inc., Willow Medtech, Inc. . Adnan Siddiqui has received research support from National PI/Steering Committees: Cerenovus EXCELLENT and ARISE II Trial; Medtronic ARTISSE IDE, SWIFT PRIME, VANTAGE, EMBOLISE and SWIFT DIRECT Trials; Terumo Neuro (formerly MicroVention) FRED Trial & CONFIDENCE Study; MUSC POSITIVE Trial; Penumbra 3D Separator Trial, COMPASS Trial, INVEST Trial, MIVI neuroscience EVAQ Trial; Rapid Medical SUCCESS Trial; InspireMD C-GUARDIANS IDE Pivotal Trial; . The institution of Adnan Siddiqui has received research support from Current Research Grants: Co-I for NSF 2304388 STTR Phase II: An AI-Enhanced Angiographic System to Guide Endovascular Treatment of Intracranial Aneurysms; Co-PI NIH OT2NS129366 / Medical University of South Carolina StrokeNet Thrombectomy Endovascular Platform (STEP); PI for Brain Aneurysm Foundation study titled Exploring the Relationship between Imaging- and Blood-Based Aneurysm Biomarkers and the Pathobiology of the Aneurysm Wall; PI for University of Cincinnati / NINDS FASTEST: rFVIIa for Acute Hemorrhagic Stroke Administered at Earliest Time Trial;. Adnan Siddiqui has received intellectual property interests from a discovery or technology relating to health care.
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Peter Kan	No disclosure on file
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Pedro Lylyk	No disclosure on file
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Aman Patel	Aman Patel has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Microvention. Aman Patel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Aman Patel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Aman Patel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Penumbra.
Adam Dmytriw (Massachusetts General Hospital)	Adam Dmytriw has nothing to disclose.

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