König I, Maurer C, Berlis A, Maus V, Weber W, Fischer S
Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum-Langendreer, In der Schornau 23-25, 44892, Bochum, Germany.
Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany.
Clin Neuroradiol. 2021 Sep;31(3):691-697. doi: 10.1007/s00062-020-00946-7. Epub 2020 Sep 3.
The concept of intrasaccular flow diversion using the Woven EndoBridge (WEB) device changed the traditional endovascular concept for wide-necked bifurcation aneurysms. The latest technical advancement resulted in the WEB 17 system, a softer device composed of fewer wires which enables treatment of smaller more distally located aneurysms by using smaller microcatheters as compared to the WEB 21 system.
This retrospective observational study aimed to evaluate and compare the angiographic and clinical results achieved with WEB 21 and WEB 17 in aneurysm morphologies eligible for both systems (maximum width 3-6 mm).
Between August 2014 and August 2019 a total of 63 and 130 aneurysms with a maximum width of 3-6 mm were treated with either WEB 21 and WEB 17, respectively, at 2 neurovascular centers. Cases were analyzed based on a comparison regarding aneurysm size, location and rupture status.
The technical success, the periprocedural complication rate and the rate of additional devices used showed no relevant differences between the two groups. Aneurysms treated with the WEB 17 system were smaller and more frequently distally located. The overall complete occlusion rate at 3 months was higher in the WEB 17 group (65.5% versus 55.1%). The superiority of complete aneurysm occlusion achieved with WEB 17 was statistically significant in the subgroup of unruptured middle cerebral artery aneurysms.
The use of WEB 17 expands the treatment indications for intrasaccular flow-diversion towards smaller and more distally located aneurysms with a safety profile comparable with that of the WEB 21.
使用编织型血管内桥接（WEB）装置进行瘤内血流分流的概念改变了宽颈分叉动脉瘤的传统血管内治疗理念。最新的技术进展产生了WEB 17系统，这是一种更柔软的装置，由更少的金属丝组成，与WEB 21系统相比，它能够使用更细的微导管治疗更小、位置更靠远心端的动脉瘤。
这项回顾性观察研究旨在评估和比较在适合两种系统（最大宽度3 - 6毫米）的动脉瘤形态中，使用WEB 21和WEB 17所取得的血管造影和临床结果。
在2014年8月至2019年8月期间，两个神经血管中心分别使用WEB 21和WEB 17治疗了最大宽度为3 - 6毫米的63个和130个动脉瘤。根据动脉瘤大小、位置和破裂状态的比较对病例进行分析。
两组之间在技术成功率、围手术期并发症发生率和额外使用装置的比例方面没有显著差异。用WEB 17系统治疗的动脉瘤更小，且更常位于远心端。WEB 17组在3个月时的总体完全闭塞率更高（65.5%对55.1%）。在未破裂的大脑中动脉瘤亚组中，WEB 17实现的动脉瘤完全闭塞的优势具有统计学意义。
WEB 17的使用扩大了瘤内血流分流的治疗适应症，可用于更小、位置更靠远心端的动脉瘤，其安全性与WEB 21相当。
