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Advanced Neurology Woven Endobridge embolization: Indications and innovation

Table 3. Wide‑neck aneurysm treatment devices with FDA approval
Year of approval Wide‑neck aneurysm treatment devices Manufacturer References
2014 Barrel Vascular Reconstruction Device Reverse Medical Corporation (Irvine, CA, USA) [56,74]
2019 Comaneci Device Rapid Medical, (Yokneam, Israel) [55,56]
2015 eCLIPS Device EVASC Neurovascular Enterprises (Vancouver, BC, [54,56]
Canada)
2017 PulseRider Aneurysm Neck Reconstruction Device Pulsar Vascular Inc., (Los Gatos, CA, USA) [53,56]
2011 Woven EndoBridge MicroVention Terumo (Aliso Viejo, CA, USA) [12,24,43,56]
All treatment devices names are as listed. Abbreviation: FDA: Food and drug administration.
also prove beneficial as it may decrease waste and provide Acknowledgments
efficiency in practice. As novel innovations for wide-neck
aneurysms continue to be investigated, it is essential to None.
continue to evaluate the effectiveness and indications of the Funding
WEB embolization device.
None.
In recent years, novel advancements in neurological
surgery, such as the WEB device, have broadened surgical Conflict of interest
and endovascular aneurysm management . The WEB
[30]
device can treat anatomically complex bifurcation The authors declare that they have no competing interests.
aneurysms, and the treatment is safer and more Author contributions
effective than the traditional approach. Conventionally,
the placement of stent-assisted coiling would require Conceptualization: Brandon Lucke-Wold, Ashley M. Carter,
antiplatelet therapy, which has the risk of hemorrhagic Bethsabe Romero
complications . Some of the advantages of the WEB Writing – original draft: All authors
[24]
device treatment are that it does not require dual Writing – review & editing: Brandon Lucke-Wold, Ashley
antiplatelet therapy, and the procedure can be performed M. Carter, Bethsabe Romero, Simran Phuyal
within a shorter timeframe, resulting in improved cost-
effectiveness and decreased anesthesia exposure . The Ethics approval and consent to participate
[61]
WEB device is currently only FDA approved to treat wide- Not applicable.
neck bifurcation aneurysms ; however, several ongoing
[24]
clinical trials are investigating the device’s suitability in Consent for publication
various intracranial aneurysms. As the results from these Not applicable.
clinical studies emerge, the device and its applications will
likely evolve. Availability of data
Recently, a multicenter study evaluated the use of the Not applicable.
WEB device in both sidewall and bifurcation intracranial
aneurysms . When 91 pairs of aneurysms were compared, References
[62]
outcomes were not significantly different between the two
groups. In particular occlusion status, device deployment 1. Cerebral Aneurysm Secondary Cerebral Aneurysm.
Available
https://www.aans.org/en/patients/
from:
success and complication rates were not significantly neurosurgical-conditions-and-treatments/cerebral-
different — indicating that the WEB device may be used aneurysm [Last accessed on 2023 Feb 27].
off-label for sidewall aneurysms. A small cohort study of
15 patients was also performed to evaluate the use of the 2. Pierot L, Moret J, Barreau X, et al., 2018, Safety and efficacy of
WEB device in posterior communicating artery (PComA) aneurysm treatment with WEB in the cumulative population
of three prospective, multicenter series. J Neurointerv Surg,
aneurysms . The authors reported complete and adequate 10: 553–559.
[63]
occlusion. Retreatment was required for two patients and
no intraoperative ruptures occurred. Considering the https://doi.org/10.1136/neurintsurg-2017-013448
common occurrence of aneurysms in the PComA and 3. Moret J, Cognard C, Weill A, et al., 1997, The “Remodelling
their rates of rupture, the off-label use of the WEB device is Technique” in the treatment of wide neck intracranial
a promising alternative for PComA aneurysms. aneurysms. Angiographic results and clinical follow-up in

Volume 2 Issue 3 (2023) 7 https://doi.org/10.36922/an.293