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Advanced Neurology

REVIEW ARTICLE
Woven Endobridge embolization: Indications

and innovation

1
Ashley M. Carter , Bethsabe Romero , Harrison Dai , Simran Phuyal ,
1
1
1
Danxun Li , and Brandon Lucke-Wold *
1
2
1 Eastern Virginia Medical School, Norfolk, Virginia, USA
2 Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
Abstract
The treatment of intracranial aneurysms has seen incredible advancements over the
last few decades. Long-term occlusion of wide-neck bifurcation aneurysms remains
technically challenging. The Woven Endobridge (WEB) embolization device is innovative
in its construction and uses. The design of the device has evolved over the last decade.
Pre-clinical and clinical trials are ongoing and continue to inform the development
of intrasaccular flow-diverting devices. The WEB device is currently approved by the
U.S. Food and Drug Administration (FDA) for treating wide-neck aneurysms. The safety
and efficacy of the WEB device have yielded promising clinical results that may have
additional indications. This review aims to discuss the development of the WEB device
and the current state of the WEB device in the treatment of wide-neck aneurysms. We
also summarize ongoing clinical studies and potential innovative uses.

Keywords: Woven Endobridge embolization device; Aneurysms; Wide-neck aneurysms;
*Corresponding author:
Brandon Lucke-Wold Posterior communicating artery aneurysms; Sidewall aneurysms; Flow-diverting device;
(brandon.lucke-wold@ Intrasaccular embolization
neurosurgery.ufl.edu)
Citation: Carter AM, Romero B,
Dai H, et al., 2023, Woven
Endobridge embolization: 1. Overview of the WEB embolization devices and current
Indications and innovation.
Adv Neuro, 2(3): 293. treatment approaches
https://doi.org/10.36922/an.293
The American Association for Neurological Surgeons (AANS) recommends three broad
Received: December 14, 2022 treatment approaches for brain aneurysms: Endovascular therapy or coiling with or
Accepted: June 1, 2023 without adjunctive devices, medical intervention, and surgical therapy or clipping .
[1]
Published Online: June 13, 2023 Endovascular strategies for treating aneurysms have demonstrated great success with
embolization coils. Despite this, long-term occlusion of wide-neck and wide-neck
Copyright: © 2023 Author(s). [2]
This is an Open-Access article bifurcation aneurysms remains technically challenging . Balloon-assisted and stent-
distributed under the terms of the assisted coiling have demonstrated safe and effective treatment of these aneurysms
Creative Commons Attribution without increased thromboembolic or iatrogenic rupture events [3-5] . However, the
License, permitting distribution, [6]
and reproduction in any medium, balloon-assisted technique risks temporary occlusion of the parent artery . Stent-
provided the original work is assisted coils eliminate the need for temporary luminal occlusion. Although they are
properly cited. effective for wide-neck aneurysms, they do not adequately treat bifurcation aneurysms
Publisher’s Note: AccScience as the second branch vessel is often left unprotected and thus risks coil herniation.
Publishing remains neutral with Various shapes have been developed to address this issue, such as the Y-stent and waffle-
regard to jurisdictional claims in [7,8]
published maps and institutional cone techniques, which generally provide better coverage ; though, the introduction of
affiliations. a stent requires prolonged use of dual antiplatelet therapy .
[9]

Volume 2 Issue 3 (2023) 1 https://doi.org/10.36922/an.293