School of Medicine, Zhejiang University, ChinaFulltext PDF
Background: Woven EndoBridge (WEB) is an innovative device for the treatment of intracranial aneurysms, especially wide-necked bifurcation aneurysms. This study aims to assess the safety and efficacy of WEB devices and analyze aneurysmal hemodynamic modifications caused by WEB deployment. Materials and Methods: We retrospectively studied 12 WEB-treated aneurysm cases (six Middle Cerebral Arteries (MCA) bifurcations, six anterior communicating Arteries (AcomA)). Clinical and imaging evaluation, aneurysm occlusion status, modified Rankin Scale (mRS) score were analyzed in the 6 months and 12 months follow-up periods. Pre-treatment and post-treatment hemodynamics based on Computational Fluid Dynamics (CFD) simulations was performed for 2 cases. Changes in wall shear stress (WSS), aneurysmal flow velocity (Velocity), and Residual Flow Volumes (RFVs) were calculated and analyzed. Results: At 12-month follow-up, 66.7% of the aneurysms had complete occlusion, 16.7% had residual neck and 16.7% had residual aneurysm. A good clinical outcome (mRS score: 0–2) was obtained in all patients without any severe treatment-related morbidity or mortality. In Case 1, the aneurysm was completely occluded, while in Case 2 the aneurysm remained residual neck after treatment. The normalized sac-averaged WSS, sac-averaged velocity, and RFVs (0.2 m/s, 0.3 m/s) were decreased by 84.9%, 70.8%, 85.9%, 98.0%, and 72.7%, 54.3%, 75.9%, and 81.1%, respectively. The reduction of the hemodynamics was more substantial in Case 1 than that in Case 2. Conclusion: The treatment of wide-neck bifurcation aneurysms with WEB devices is feasible with an acceptable safety and efficacy rate. Hemodynamic changes may predict the occlusion outcome of wide-necked bifurcation aneurysms treated by WEB.
Xu J. The Woven EndoBridge Device for Treatment of Bifurcation Aneurysms: Image-Based Computational Hemodynamic Analysis. Clin Surg. 2022; 7: 3435..