Risk Factors of Procedural Complications Related to Woven EndoBridge (WEB) Embolization of Intracranial Aneurysms.

PURPOSE

The Woven EndoBridge (WEB) device has been proven to be a safe and efficient endovascular treatment option for wide-necked bifurcation aneurysms. The study aimed to evaluate the incidence and risk factors of procedural complications related to WEB embolization of ruptured and unruptured intracranial aneurysms.

METHODS

This was a multicenter, observational study of consecutive patients with ruptured and unruptured aneurysms who were treated with the WEB at three German tertiary care centers between May 2011 and February 2018. Patient characteristics, anatomical details and procedural aspects were retrospectively collected and the impact on procedure-related complications was evaluated.

RESULTS

Among 120 patients (mean age 58.5 ± 11.9 years) with 120 aneurysms (mean size: 8.5 ± 4.5 mm), WEB implantation was successful in 112 patients (93.3%). The rates for overall and symptomatic complications were 11.7% and 5.0%, respectively. At 6‑month follow-up device-related morbidity was 1.2% among unruptured aneurysms and 2.6% among ruptured aneurysms. In the univariate analysis, a lower aspect ratio (p = 0.04) and an increased width-to-height ratio (p = 0.03) were significant risk factors for procedural complications.

CONCLUSION

The results of this study confirmed the WEB to be a safe treatment option, which is associated with low complication rates and minimal morbidity. Complications tended to occur more often in aneurysms with an unfavorable ratio between aneurysm height and aneurysm/neck width.