Incidence and predictors of Woven EndoBridge (WEB) shape modification following treatment of intracranial aneurysms in a large multicenter study
The Woven EndoBridge (WEB) device is FDA-approved for the treatment of bifurcation aneurysms. Despite its wide popularity, it has been under scrutiny for its association with potential aneurysm recanalization and retreatment due to device shape modification. This study aims to analyze the shape modification rate of WEB devices and identify factors associated with this phenomenon, as well as its correlation with aneurysm retreatment. We conducted a retrospective review of the WorldWide WEB Consortium database, including adult patients treated for intracranial aneurysms with the WEB device. We assessed aneurysm occlusion using the WEB Occlusion Scale and defined WEB shape modification as a percentage reduction in the distance between two WEB markers. Logistic regression and Cox proportional hazards models were utilized to evaluate predictors of shape modification and retreatment. Kaplan-Meier curves were used to estimate the time-dependent probability of no or minor shape modification. A total of 405 patients were analyzed, with minor and major shape modification occurring in 31.4% and 10.1% of cases, respectively. Major shape modification was associated with lower rates of adequate occlusion (70.7%) compared to no or minor shape modification (86.6%) and a higher rate of retreatment (26.8% vs. 8.1%). Predictors of major shape modification included the presence of daughter sac, bifurcation aneurysms, absence of immediate flow stagnation, and a WEB width minus aneurysm width ratio ≤ 0.5. The probability of no or minor shape modification declined within the first 25 months and stabilized thereafter. WEB device shape modification is a significant predictor of aneurysm occlusion efficacy and retreatment. Recognizing the factors influencing shape modification can guide treatment decisions and follow-up protocols to improve patient outcomes.
Authors
- Sunil A. Sheth (ORCID: https://orcid.org/0000-0003-0602-8509)
- Joshua S. Catapano (ORCID: https://orcid.org/0000-0001-6599-0269)
- Mohamed M. Salem (ORCID: https://orcid.org/0000-0002-2082-6892)
- Eytan Raz (ORCID: https://orcid.org/0000-0003-2998-8481)
- Thien J Huynh (ORCID: https://orcid.org/0000-0001-9319-952X)
- Jose Danilo Bengzon Diestro (ORCID: https://orcid.org/0000-0001-8450-2021)
- Assala Aslan (ORCID: https://orcid.org/0000-0001-8797-0808)
- Ajit S Puri (ORCID: https://orcid.org/0000-0002-6978-6457)
- Hamza A. Shaikh (ORCID: https://orcid.org/0000-0001-8163-4600)
- Oktay Algın (ORCID: https://orcid.org/0000-0002-3877-8366)
- Benjamin Pulli (ORCID: https://orcid.org/0000-0002-1795-9897)
- Vedran Župančić (ORCID: https://orcid.org/0000-0002-1495-4345)
- Muhammad Ubaid Hafeez (ORCID: https://orcid.org/0000-0001-8631-4227)
- Neil Haranhalli (ORCID: https://orcid.org/0000-0003-2721-8600)
- Guillaume Saliou (ORCID: https://orcid.org/0000-0003-3832-7976)
- Mark Ogilvie (ORCID: https://orcid.org/0000-0001-8226-762X)
- Jan‐Karl Burkhardt
- Hamza Adel Salim (ORCID: https://orcid.org/0000-0002-5208-8425)
- Sovann V. Lay (ORCID: https://orcid.org/0000-0003-4105-0664)
- Elad I. Levy (ORCID: https://orcid.org/0000-0002-6208-3724)
- Guglielmo Pero (ORCID: https://orcid.org/0000-0002-8932-6909)
- Charlotte Y. Chung (ORCID: https://orcid.org/0000-0003-0671-4111)
- Pietro Panni (ORCID: https://orcid.org/0000-0001-8109-9118)
- James D. Rabinov (ORCID: https://orcid.org/0000-0003-2410-5061)
- Nimer Adeeb (ORCID: https://orcid.org/0000-0002-8668-7629)
- Juan Carlos Martínez-Gutiérrez (ORCID: https://orcid.org/0000-0002-6722-8267)
- David Altschul (ORCID: https://orcid.org/0000-0002-5130-1378)
- Christopher J. Stapleton (ORCID: https://orcid.org/0000-0003-4805-0093)
- Rabih G. Tawk (ORCID: https://orcid.org/0000-0002-2695-0042)
- Kareem El Naamani (ORCID: https://orcid.org/0000-0001-5294-1003)
- Paul M. Foreman (ORCID: https://orcid.org/0000-0001-8743-5119)
- Adnan H. Siddiqui (ORCID: https://orcid.org/0000-0002-9519-0059)
- Muhammed Amir Essibayi (ORCID: https://orcid.org/0000-0001-8325-2382)
- Boris Lubicz (ORCID: https://orcid.org/0000-0001-8312-2115)
- Srikanth Boddu (ORCID: https://orcid.org/0000-0003-2863-5094)
- Jesse George Atherton Jones (ORCID: https://orcid.org/0000-0002-2682-9736)
- Mahmoud Dibas (ORCID: https://orcid.org/0000-0003-1690-1084)
- Clemens Maria Schirmer (ORCID: https://orcid.org/0000-0003-1743-8781)
- Onur Ergün (ORCID: https://orcid.org/0000-0002-0495-0500)
- Iván Lylyk (ORCID: https://orcid.org/0000-0002-6048-4225)
- Anna Luisa Kühn (ORCID: https://orcid.org/0000-0001-9512-9461)
- Adam Andrew Dmytriw (ORCID: https://orcid.org/0000-0003-0131-5699)
- Sherief A. Ghozy (ORCID: https://orcid.org/0000-0001-5629-3023)
- Leonardo Renieri (ORCID: https://orcid.org/0000-0001-8966-8266)
- Waleed Brinjikji (ORCID: https://orcid.org/0000-0001-5271-5524)
- Peter Kan (ORCID: https://orcid.org/0000-0001-6649-4128)
- Anh Nguyên (ORCID: https://orcid.org/0000-0002-9343-8276)
- Max Wintermark (ORCID: https://orcid.org/0000-0002-6726-3951)
- Diana Slawski (ORCID: https://orcid.org/0000-0001-5516-8968)
- Christian Ulfert (ORCID: https://orcid.org/0000-0003-3642-350X)
- Nicola Limbucci (ORCID: https://orcid.org/0000-0002-0432-5414)
- Joseph A. Carnevale (ORCID: https://orcid.org/0000-0002-9477-9996)
- Yifan Ren (ORCID: https://orcid.org/0000-0001-6518-6828)
- Caterina Michelozzi (ORCID: https://orcid.org/0000-0001-6339-448X)
- Marie Teresa Nawka (ORCID: https://orcid.org/0000-0001-7423-9725)
- Pascal M. Jabbour (ORCID: https://orcid.org/0000-0002-8965-2413)
- Vladimir Kalousek (ORCID: https://orcid.org/0000-0002-1439-0930)
- Felipe C. Albuquerque (ORCID: https://orcid.org/0000-0003-2655-3810)
- Panagiotis Mastorakos (ORCID: https://orcid.org/0000-0003-0505-6938)
- Stavropoula I Tjoumakaris
- Michael Kral (ORCID: https://orcid.org/0000-0003-3496-8872)
- Martin Cuellar Torriente (ORCID: https://orcid.org/0000-0003-2068-0325)
- Ameer E Hassan (ORCID: https://orcid.org/0000-0002-7148-7616)
- Vivek Srikar Yedavalli (ORCID: https://orcid.org/0000-0002-2450-4014)
- Vítor Mendes Pereira (ORCID: https://orcid.org/0000-0002-6804-3985)
- Hugo Cuellar (ORCID: https://orcid.org/0000-0002-8348-4535)
- Hamed Asadi (ORCID: https://orcid.org/0000-0003-2475-9727)
- Jared Knopman (ORCID: https://orcid.org/0000-0001-5871-5517)
- Adrien Guenego (ORCID: https://orcid.org/0000-0001-7281-1652)
- Mariangela Piano (ORCID: https://orcid.org/0000-0003-0470-1202)
- Basel Musmar (ORCID: https://orcid.org/0009-0000-4910-6090)
- Eimad Shotar (ORCID: https://orcid.org/0000-0002-8712-8431)
- Aman B. Patel (ORCID: https://orcid.org/0000-0001-9022-411X)
- Muhammad Waqas (ORCID: https://orcid.org/0000-0003-4500-7954)
- Muhammet Arslan (ORCID: https://orcid.org/0000-0001-5565-0770)
- Pedro Lylyk (ORCID: https://orcid.org/0000-0001-9704-2175)
- Andrew F. Ducruet (ORCID: https://orcid.org/0000-0002-9185-0849)
- Markus Möhlenbruch
- Christian Swaid
- Robert W. Regenhardt (ORCID: https://orcid.org/0000-0003-2958-3484)
- Nicole M. Cancelliere
- Christoph J. Griessenauer
- Bryan Pukenas (ORCID: https://orcid.org/0000-0001-7452-6804)
- Robert M. Starke
- Marios Psychogios
- Frédéric Clarençon
Institutions
- Geisinger Medical Center (US)
- St. Michael's Hospital (CA)
- Albert Einstein College of Medicine (US)
- Barrow Neurological Institute (US)
- Montefiore Medical Center (US)
- NewYork–Presbyterian Hospital (US)
- The University of Texas MD Anderson Cancer Center (US)
- Harvard University (US)
- Johns Hopkins University (US)
- University of Miami (US)
- Orlando Health (US)
- Ankara University (TR)
- Universität Hamburg (DE)
- University of Toronto (CA)
- Cornell University (US)
- Heidelberg University (DE)
- Louisiana State University in Shreveport (US)
- Thomas Jefferson University Hospital (US)
- New York Hospital Queens (US)
- Erasmus Hospital (BE)
- University Hospital Heidelberg (DE)
- Centre Hospitalier Universitaire Vaudois (CH)
- WinnMed (US)
- University Hospital of Basel (CH)
- Johns Hopkins Bayview Medical Center (US)
- Centre Hospitalier Universitaire de Toulouse (FR)
- University of Alabama at Birmingham (US)
- Sorbonne Université (FR)
- NYU Langone Health (US)
- Massachusetts General Hospital (US)
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
- Presbyterian Hospital (US)
- Christian Doppler Klinik (AT)
- Baylor School (US)
- University Medical Center Hamburg-Eppendorf (DE)
- Pitié-Salpêtrière Hospital (FR)
- Mayo Clinic in Arizona (US)
- Valley Baptist Medical Center (US)
- IRCCS Ospedale San Raffaele (IT)
- Mayo Clinic in Florida (US)
- Memorial Hospital (US)
- Austin Health (AU)
- Pamukkale University (TR)
- University at Buffalo, State University of New York (US)
- University of Pennsylvania (US)
- The University of Texas Health Science Center at Houston (US)
- Stanford University (US)
Publication Details
- Journal
- Neurosurgical Review
- Published
- 2025-02-24
- DOI
- https://doi.org/10.1007/s10143-025-03344-0
- Citations
- 3
- Primary Topic
- Intracranial Aneurysms: Treatment and Complications
- Type
- article
- Field-Weighted Citation Impact
- 4.17