Goertz Lukas, Liebig Thomas, Siebert Eberhard, Herzberg Moriz, Neuschmelting Hannah, Borggrefe Jan, Onur Özgür A, Dorn Franziska, Kabbasch Christoph
Department of Neuroradiology, University Hospital of Cologne, Kerpener Straße 67, 50937, Cologne, Germany.
Center for Neurosurgery, University Hospital of Cologne, Kerpener Straße 67, 50937, Cologne, Germany.
Clin Neuroradiol. 2020 Jun;30(2):297-304. doi: 10.1007/s00062-019-00762-8. Epub 2019 Feb 7.
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.
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.
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.
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.
编织型血管内桥接（WEB）装置已被证明是治疗宽颈分叉动脉瘤安全有效的血管内治疗选择。本研究旨在评估与破裂和未破裂颅内动脉瘤的WEB栓塞相关的手术并发症的发生率及危险因素。
这是一项多中心观察性研究，纳入2011年5月至2018年2月期间在德国三个三级医疗中心接受WEB治疗的连续的破裂和未破裂动脉瘤患者。回顾性收集患者特征、解剖细节和手术相关情况，并评估其对手术相关并发症的影响。
120例患者（平均年龄58.5±11.9岁）共120个动脉瘤（平均大小：8.5±4.5mm），112例患者（93.3%）WEB植入成功。总体并发症发生率和有症状并发症发生率分别为11.7%和5.0%。在6个月随访时，未破裂动脉瘤的装置相关发病率为1.2%，破裂动脉瘤为2.6%。单因素分析中，较低的纵横比（p=0.04）和增大的宽高比（p=0.03）是手术并发症的显著危险因素。
本研究结果证实WEB是一种安全的治疗选择，并发症发生率低，发病率最小。并发症往往更常发生在动脉瘤高度与动脉瘤/颈部宽度比例不佳的动脉瘤中。
