Stanca Carmelo, Carriero Serena, Negroni Davide, Spinetta Marco, Coda Carolina, Biondetti Pierpaolo, Guzzardi Giuseppe
Maggiore della Carità Hospital of Novara, 28100 Novara, Italy.
Radiodiagnostic and Interventional Radiology Department, Università degli Studi di Milano, 20122 Milan, Italy.
J Clin Med. 2022 May 19;11(10):2879. doi: 10.3390/jcm11102879.
The Woven EndoBridge (WEB) device is a self-expanding intrasaccular braided-wire device for the treatment of wide-neck bifurcation aneurysms (WNBAs). Even though this device has an excellent safety profile and a low risk of rebleeding, little is known about its long-term effects.
All patients treated with WEB due to ruptured WNBAs were subjected to follow-up digital subtraction angiography (DSA) at 2 and 3 years after device deployment. The degree of residual neck was assessed through BOSS, Lubicz, and WEBCAST scales. Data on modified Rankin scale (mRS), bleeding events, and ischemic events occurring during this time period were collected as well. Lastly, overall and procedure-related mortality rates were calculated.
A total of 21 patients were treated between 1 January 2016, and 31 December 2018. DSA demonstrated a patency grade of 57.1% and 61.1% at 2 and 3 years, respectively. The overall 2-year mortality rate due to causes unrelated to the aneurysm was 14.3%. None of the patients were retreated between the 2- and the 3-year follow-up. No rebleeding or stroke events occurred during the follow-up.
WEB-treated ruptured aneurysms showed an excellent degree of stability over time. The overall mortality rate-unrelated to the procedure-observed in our sample was higher than what reported in the literature, a possible bias associated with the COVID-19 pandemic.
编织型血管内桥接器（WEB）是一种用于治疗宽颈分叉动脉瘤（WNBA）的自膨式囊内编织金属丝装置。尽管该装置具有出色的安全性和较低的再出血风险，但其长期影响仍知之甚少。
所有因破裂性WNBA接受WEB治疗的患者在装置植入后2年和3年接受随访数字减影血管造影（DSA）。通过BOSS、Lubicz和WEBCAST量表评估残余瘤颈程度。同时收集此期间改良Rankin量表（mRS）、出血事件和缺血事件的数据。最后，计算总体死亡率和与手术相关的死亡率。
2016年1月1日至2018年12月31日期间共治疗21例患者。DSA显示在2年和3年时通畅率分别为57.1%和61.1%。与动脉瘤无关原因导致的2年总体死亡率为14.3%。2年至3年随访期间无患者接受再次治疗。随访期间未发生再出血或卒中事件。
接受WEB治疗的破裂动脉瘤随时间推移显示出极佳的稳定性。我们样本中观察到的与手术无关的总体死亡率高于文献报道，这可能与2019冠状病毒病大流行相关的偏倚有关。
