title: The Woven Endobridge Device for Treatment of Intracranial Aneurysms: A Systematic Review.
abstract: BACKGROUND
  The Woven Endobridge (WEB) device is an innovative endovascular device for treatment of intracranial aneurysms, especially bifurcation and wide-neck aneurysms. Although not approved by the U.S. Food and Drug Administration, it has been available in Europe since 2011. The aim of this review is to evaluate the outcomes of WEB device use for intracranial aneurysm treatment.
  
  
  METHODS
  A systematic review was conducted with MEDLINE search engines PubMed and Embase from 2011. The search strategy provided 6229 articles, and 19 articles were included.
  
  
  RESULTS
  A total of 19 papers were identified describing the use of WEB devices in 687 patients with 718 aneurysms. The 2 largest prospective multicenter studies (WEBCAST and the French Observatory Trial) reported successful treatment, defined as complete closure or a neck remnant, in 85% and 79% of aneurysms, respectively. The use of a WEB device in combination with coiling or stenting was described with varying results in multiple small series. Outcomes of WEB device use in ruptured aneurysms in 2 studies showed 94% and 80% adequate treatment. Thromboembolic events were described in 71 patients (10.3% of all patients) and infarctions in 8 patients (1.2% of all patients).
  
  
  CONCLUSIONS
  Despite initial promising results, the WEB device should be used with caution given its potentially large learning curve and because it has primarily been investigated only in wide-neck and bifurcation aneurysms. In addition, currently available prospective studies have short follow-up, and the device has not been directly compared with other treatment modalities.
authors.affiliation: Department of Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands; Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Ivo S
authors.initials: IS
authors.lastname: Muskens
authors.affiliation: Department of Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands; Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Joeky T
authors.initials: JT
authors.lastname: Senders
authors.affiliation: Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Hormuzdiyar H
authors.initials: HH
authors.lastname: Dasenbrock
authors.affiliation: Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Timothy R S
authors.initials: TR
authors.lastname: Smith
authors.affiliation: Department of Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands; Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA. Electronic address: M.L.D.Broekman-4@umcutrecht.nl.
authors.forename: Marike L D
authors.initials: ML
authors.lastname: Broekman
mesh_terms: D017542:Aneurysm, Ruptured / Q000601:surgery*; D000818:Animals; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D004812:Epidemiologic Methods; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011817:Rabbits; D013923:Thromboembolism / Q000209:etiology; D016896:Treatment Outcome
keywords: Endovascular treatment; Intracranial aneurysm; WEB device