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Purpose <p>Although the Woven EndoBridge (WEB) device is increasingly used for the treatment of wide-neck intracranial aneurysms, including in the acute rupture setting, comparative evidence assessing the impact of rupture status remains limited. This study compared angiographic, safety, and clinical outcomes between ruptured and unruptured intracranial aneurysms treated with WEB.</p> Methods <p>We conducted a retrospective analysis of prospectively collected data from the multicenter cohort registry WorldWideWEB, including consecutive adult patients with intracranial aneurysms treated with the WEB. Patients were stratified into groups of ruptured and unruptured aneurysms. Propensity score matching was used to balance baseline characteristics between both groups. Retreatment rate was the primary outcome. Secondary outcomes included mRS, safety events (thromboembolic complications) and angiographic outcomes (periprocedurally and last follow-up).</p> Results <p>Among 1,220 patients, 342 (28.0%) presented with ruptured aneurysms. Propensity-score-matched analyses revealed no significant difference in thromboembolic complications (11.8% vs. 5.9%, <i>p</i> = 0.056), similar periprocedural adequate occlusion (53.3% vs. 53.8%, <i>p</i> &gt; 0.9), and similar retreatment rates (11.8% (95% CI 7.8–17.6%) vs. 7.1% (95% CI 4.1–12.0%), <i>p</i> = 0.14); however, adequate occlusion at follow-up was lower (82.2% vs. 93.3%, <i>p</i> = 0.002) and functional outcomes were worse (mRS ≥ 2 in 34.1% vs. 21.9%, <i>p</i> = 0.012) among patients with ruptured aneurysms.</p> Conclusion <p>Ruptured aneurysms demonstrated expected inferior follow-up functional and angiographic outcomes when compared with unruptured aneurysms, but no difference in retreatment rate and procedural safety. These findings support WEB as a safe and effective treatment option for appropriately selected ruptured intracranial aneurysms in routine clinical practice.</p>

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Woven Endobridge device for ruptured vs. unruptured aneurysms: insights from the WorldWideWEB study

  • 期刊论文

  • 发表日期：

    2026年5月18日

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  • Franja Dugar,
  • Muhammed Amir Essibayi,
  • Hamza Adel Salim,
  • Basel Musmar,
  • Nimer Adeeb,
  • Mahmoud Dibas,
  • Yan-Lin Li,
  • Oktay Algin,
  • Sherief Ghozy,
  • Sovann V. Lay,
  • Adrien Guenego,
  • Leonardo Renieri,
  • Joseph Carnevale,
  • Guillaume Saliou,
  • Panagiotis Mastorakos,
  • Eimad Shotar,
  • Markus Möhlenbruch,
  • Michael Kral,
  • Charlotte Chung,
  • Mohamed M. Salem,
  • Ivan Lylyk,
  • Nicole M. Cancelliere,
  • Jose Danilo Bengzon Diestro,
  • Paul M. Foreman,
  • Hamza Shaikh,
  • Vedran Župančić,
  • Muhammad U. Hafeez,
  • Joshua Catapano,
  • Muhammad Waqas,
  • Giyas Ayberk,
  • Muhammet Arslan,
  • James D. Rabinov,
  • Onur Ergun,
  • Julian Maingard,
  • Clemens M. Schirmer,
  • Mariangela Piano,
  • Anna L. Kühn,
  • Caterina Michelozzi,
  • Robert M. Starke,
  • Ameer Hassan,
  • Mark Ogilvie,
  • Jesse Jones,
  • Waleed Brinjikji,
  • Fulvio Zaccagna,
  • James T. Grist,
  • Marios Psychogios,
  • Marie T. Nawka,
  • Jens Fiehler,
  • Thi Dan Linh Nguyen-Kim,
  • Bryan Pukenas,
  • Jan-Karl Burkhardt,
  • Thien Huynh,
  • Juan Carlos Martinez-Gutierrez,
  • Sunil A. Sheth,
  • Diana Slawski,
  • Rabih G. Tawk,
  • Benjamin Pulli,
  • Boris Lubicz,
  • Pietro Panni,
  • Ajit S. Puri,
  • Guglielmo Pero,
  • Eytan Raz,
  • Christoph J. Griessenauer,
  • Hamed Asadi,
  • Adnan Siddiqui,
  • Elad I Levy,
  • Neil Haranhalli,
  • David Altschul,
  • Andrew F. Ducruet,
  • Robert W. Regenhardt,
  • Christopher J. Stapleton,
  • Peter Kan,
  • Vladimir Kalousek,
  • Pedro Lylyk,
  • Srikanth Boddu,
  • Jared Knopman,
  • Stavropoula I. Tjoumakaris,
  • Hugo H. Cuellar-Saenz,
  • Pascal M. Jabbour,
  • Frédéric Clarençon,
  • Nicola Limbucci,
  • Tufail Patankar,
  • Vitor Mendes Pereira,
  • Aman B. Patel,
  • Mohammad Almohammad,
  • Andre Kemmling,
  • Luca Scarcia,
  • Adam A. Dmytriw,
  • Peter B. Sporns

摘要

Purpose

Although the Woven EndoBridge (WEB) device is increasingly used for the treatment of wide-neck intracranial aneurysms, including in the acute rupture setting, comparative evidence assessing the impact of rupture status remains limited. This study compared angiographic, safety, and clinical outcomes between ruptured and unruptured intracranial aneurysms treated with WEB.

Methods

We conducted a retrospective analysis of prospectively collected data from the multicenter cohort registry WorldWideWEB, including consecutive adult patients with intracranial aneurysms treated with the WEB. Patients were stratified into groups of ruptured and unruptured aneurysms. Propensity score matching was used to balance baseline characteristics between both groups. Retreatment rate was the primary outcome. Secondary outcomes included mRS, safety events (thromboembolic complications) and angiographic outcomes (periprocedurally and last follow-up).

Results

Among 1,220 patients, 342 (28.0%) presented with ruptured aneurysms. Propensity-score-matched analyses revealed no significant difference in thromboembolic complications (11.8% vs. 5.9%, p = 0.056), similar periprocedural adequate occlusion (53.3% vs. 53.8%, p > 0.9), and similar retreatment rates (11.8% (95% CI 7.8–17.6%) vs. 7.1% (95% CI 4.1–12.0%), p = 0.14); however, adequate occlusion at follow-up was lower (82.2% vs. 93.3%, p = 0.002) and functional outcomes were worse (mRS ≥ 2 in 34.1% vs. 21.9%, p = 0.012) among patients with ruptured aneurysms.

Conclusion

Ruptured aneurysms demonstrated expected inferior follow-up functional and angiographic outcomes when compared with unruptured aneurysms, but no difference in retreatment rate and procedural safety. These findings support WEB as a safe and effective treatment option for appropriately selected ruptured intracranial aneurysms in routine clinical practice.