Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA.
Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Neurosurg Rev. 2024 Jul 31;47(1):374. doi: 10.1007/s10143-024-02527-5.
The Woven EndoBridge (WEB) device is primarily used for treating wide-neck intracranial bifurcation aneurysms under 10 mm. Limited data exists on its efficacy for large aneurysms. We aim to assess angiographic and clinical outcomes of the WEB device in treating large versus small aneurysms. We conducted a retrospective review of the WorldWide WEB Consortium database, from 2011 to 2022, across 30 academic institutions globally. Propensity score matching (PSM) was employed to compare small and large aneurysms on baseline characteristics. A total of 898 patients were included. There was no significant difference observed in clinical presentations, smoking status, pretreatment mRS, presence of multiple aneurysms, bifurcation location, or prior treatment between the two groups. After PSM, 302 matched pairs showed significantly lower last follow-up adequate occlusion rates (81% vs 90%, p = 0.006) and higher retreatment rates (12% vs 3.6%, p < 0.001) in the large aneurysm group. These findings may inform treatment decisions and patient counseling. Future studies are needed to further explore this area.
编织式支架（WEB）装置主要用于治疗 10mm 以下宽颈颅内分叉部动脉瘤。关于其治疗大型动脉瘤的疗效数据有限。我们旨在评估 WEB 装置治疗大型和小型动脉瘤的血管造影和临床结果。我们对 2011 年至 2022 年期间全球 30 家学术机构的 WorldWide WEB 联盟数据库进行了回顾性研究。采用倾向评分匹配（PSM）比较两组患者的基线特征。共纳入 898 例患者。两组患者在临床表现、吸烟状况、治疗前 mRS 评分、多发性动脉瘤、分叉部位或既往治疗方面无显著差异。PSM 后，302 对匹配对显示大型动脉瘤组的末次随访时充分闭塞率（81%比 90%，p=0.006）显著降低，再治疗率（12%比 3.6%，p<0.001）较高。这些发现可能为治疗决策和患者咨询提供信息。需要进一步的研究来探索这一领域。
