title: Efficacy and Safety of the Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis.
abstract: Intrasaccular flow diverters are increasingly being used in the treatment of wide-neck and bifurcation aneurysms. We performed a systematic review and meta-analysis of existing literature on the Woven EndoBridge device in the treatment of intracranial aneurysms.
  
  
  
  A comprehensive literature search was performed through October 1, 2015. We extracted information on baseline aneurysm and patient characteristics. Outcomes studied included immediate and midterm (>3 month) angiographic outcomes (complete occlusion as well as adequate occlusion, defined as complete occlusion or neck remnant), aneurysm retreatment, intraoperative rupture, perioperative morbidity and mortality, thromboembolic complications, and treatment failure. Meta-analysis was performed by using the random-effects model.
  
  
  
  Fifteen uncontrolled series were included in this analysis, including 565 patients with 588 aneurysms, of which 127 were ruptured. Initial complete and adequate occlusion rates were 27% (95% CI, 15%-39%) and 59% (95% CI, 39%-78%), respectively. Midterm complete and adequate occlusion rates after a median of 7 months were 39% (95% CI, 26%-52%) and 85% (95% CI, 78%-91%), respectively. Perioperative morbidity and mortality rates were 4% (95% CI, 1%-8%) and 1% (95% CI, 0%-2%), respectively. Midterm adequate occlusion rates for ruptured aneurysms were 85% (95% CI, 67%-98%), compared with 84% (95% CI, 72%-94%) for unruptured aneurysms (P = .89). Patients with ruptured aneurysm had similar rates of perioperative morbidity to patients with unruptured aneurysm (2%; 95% CI, 0%-26% versus 2%; 95% CI, 0%-6%, respectively; P = .35).
  
  
  
  Early evidence derived from uncontrolled studies suggests that Woven EndoBridge treatment has a good safety profile and promising rates of adequate occlusion, especially given the complexity of aneurysms treated. Further prospective clinical trials are needed to confirm these results and better define the risks and benefits of use of the Woven EndoBridge device in treating wide-neck and wide-neck bifurcation aneurysms.
authors: From the Department of Radiology (S.A., A.R., W.B., D.F.K.).
authors: S
authors: 0000-0003-4059-167X
authors: S
authors: Asnafi
authors: From the Department of Radiology (S.A., A.R., W.B., D.F.K.).
authors: A
authors: 0000-0003-0902-3375
authors: A
authors: Rouchaud
authors: Department of Neuroradiology (L.P.), Maison Blanche Hospital, University of Reims Champagne-Ardenne, Reims, France.
authors: L
authors: 0000-0002-2523-4909
authors: L
authors: Pierot
authors: From the Department of Radiology (S.A., A.R., W.B., D.F.K.) brinjikji.waleed@mayo.edu.
authors: W
authors: 0000-0001-5271-5524
authors: W
authors: Brinjikji
authors: Center for the Science of Healthcare Delivery (M.H.M.), Mayo Clinic, Rochester, Minnesota.
authors: M H
authors: 0000-0001-5502-5975
authors: MH
authors: Murad
authors: From the Department of Radiology (S.A., A.R., W.B., D.F.K.).
authors: D F
authors: 0000-0002-8495-0040
authors: DF
authors: Kallmes
mesh_terms: D017542:Aneurysm, Ruptured / Q000628:therapy; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure; D016896:Treatment Outcome