Clinicians report real-world results on the use of a new device to treat brain aneurysms
A recent international study led by researchers at Massachusetts General Hospital (MGH) and other institutions offers real-world results on the use of a novel device for treating brain aneurysms, or balloon-like bulges on weakened blood vessels that can rupture to cause life-threatening bleeding.
The study, which is published in Stroke, involved the use of the Woven Endobridge (WEB) device. This device consists of a tiny mesh plug that can be inserted through a vessel and placed into an aneurysm to block, or occlude, blood from going into the bulging region — thereby stabilizing the vessel and preventing the aneurysm from rupturing. The device can also be used to stabilize previously ruptured aneurysms.
“The WEB has recently become available in the United States, and elsewhere across the globe the device has been available for a longer time — but no large-scale study of its efficacy had yet been performed,” says lead author Adam A. Dmytriw, MD, MPH, MSc, an interventional neuroradiology and endovascular neurosurgery fellow at MGH. “Thus, we founded the WorldWideWEB Consortium uniting the experience of 22 tertiary/quaternary institutions across North America, Europe, South America, and Australia.”
The team found that among 671 patients with 683 brain aneurysms (26.2% previously ruptured) who were treated with the device and were followed for a median of 11 months, adequate occlusion occurred in 85.7% of aneurysms, and complete occlusion in 57.8%. Retreatment was required in 7.8% of aneurysms. Blood clot-related complications developed in 7.5% of procedures, of which only 4.0% were symptomatic and 2.0% were permanent. Bleeding complications occurred in 3.0% of procedures. No patients experienced aneurysm re-rupture after treatment.
“Patients who are not suitable for open aneurysm surgery or who have recently had a life-threatening rupture and would be at high risk for additional bleeding if treated with conventional endovascular techniques due to the need for blood thinners, now have a viable treatment option,” says Dmytriw. “We hope that our results will help guide interventionalists in the appropriate use of the WEB so that patients with challenging brain aneurysms will have a safe option for care.”
Addition medical institutions continue to join the consortium, which plans to conduct additional studies to assess the use of the WEB for diverse types of aneurysms and to examine potential challenges to its use.
- Adam A. Dmytriw, Jose Danilo Bengzon Diestro, Mahmoud Dibas, Kevin Phan, Ahmad Sweid, Hugo H. Cuellar-Saenz, Sovann V. Lay, Adrien Guenego, Leonardo Renieri, Ali Al Balushi, Sri Hari Sundararajan, Joseph Carnevale, Guillaume Saliou, Markus Möhlenbruch, Justin E. Vranic, James D. Rabinov, Ivan Lylyk, Paul M. Foreman, Jay A. Vachhani, Vedran Župančić, Muhammad U. Hafeez, Caleb Rutledge, Muhammad Waqas, Vincent M. Tutino, Rawad Abbas, Yasuaki Inoue, Carolina Capirossi, Yifan Ren, Clemens M. Schirmer, Mariangela Piano, Anna Luisa Kühn, Caterina Michelozzi, Stéphanie Elens, Robert W. Regenhardt, Sherief Ghozy, Naif M. Alotaibi, Stavropoula Tjoumakaris, Robert M. Starke, Boris Lubicz, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Christoph J. Griessenauer, Hamed Asadi, Mark Brooks, Julian Maingard, Ashu Jhamb, Adnan Siddiqui, Andrew F. Ducruet, Felipe C. Albuquerque, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Amey Savardekar, Srikanth Boddu, Jared Knopman, Nicola Limbucci, Karen S. Chen, Mohammad A. Aziz-Sultan, Christopher J. Stapleton, Pascal Jabbour, Christophe Cognard, Aman B. Patel, Nimer Adeeb. International Study of Intracranial Aneurysm Treatment Using Woven EndoBridge: Results of the WorldWideWEB Consortium. Stroke, 2021; DOI: 1161/STROKEAHA.121.037609