Safety and efficacy of the Woven EndoBridge (WEB) device in ruptured intracranial aneurysms: a systematic review and updated meta-analysis.

BACKGROUND

The Woven EndoBridge (WEB; Terumo) device has gained increasing recognition for treating ruptured intracranial aneurysms (RIAs) due to its ability to disrupt flow with a single implant, avoiding long-term dual antiplatelet therapy. Despite multiple studies, a comprehensive synthesis of recent evidence remains lacking. This study addresses this gap through a systematic review and meta-analysis evaluating the WEB device's safety and efficacy in RIA management.

METHODS

A systematic search of EMBASE, MEDLINE, Scopus, Cochrane, and the Web of Science identified studies on WEB treatment for RIAs up to January 2025. Key outcomes included implantation success, rebleeding, occlusion, retreatment, good functional outcomes (mRS 0-2) at 90 days, morbidity, mortality, and complications. A single-arm proportion analysis was conducted under a random-effects model.

RESULTS

Twenty-five studies with 1,065 patients (1,077 aneurysms) were included. The implantation success rate was 98.04%, and rebleeding occurred in 0.33% of cases. Adequate and complete occlusion at 12 months were 83.77% and 59.42%, respectively. Good functional outcomes at 90 days were 87.27%, with a retreatment rate of 7.54%. Procedure-related mortality and morbidity were 0.39% and 1.39%. The overall complication rate was 12.82%, with thromboembolic and hemorrhagic events in 4.55% and 1.05% of cases, respectively.

CONCLUSION

Our findings indicate that the WEB device is a safe and effective treatment for RIAs, offering high rates of adequate occlusion, good functional outcomes, and low complication rates. This evidence reaffirms the WEB device's safety and efficacy, supporting its wider adoption in clinical use.