Introduction: Flow Disruption with WEB is an innovative endovascular approach for wide-neck bifurcation aneurysms. Initial series have shown a low complication rate with good efficacy.
Hypothesis: To confirm the safety and efficacy of the WEB aneurysm treatment in the cumulated population of WEBCAST (WEB Clinical Assessment of Intrasaccular Aneurysm), French Observatory, and WEBCAST 2 series.
Methods: WEBCAST, WEBCAST 2, and French Observatory are single-arm, prospective, multicenter, GCP (Good Clinical Practice) studies dedicated to the evaluation of WEB treatment, conducted in Europe and France. Inclusion criteria were ruptured and unruptured aneurysms in both studies, located in basilar artery, middle cerebral artery, anterior communicating artery, and internal carotid artery terminus. Clinical data were independently evaluated. Post-operative, 6-months (in WEBCAST and WEBCAST 2), and 1-year aneurysm occlusion was independently evaluated using the 3-grade scale: complete occlusion, neck remnant, and aneurysm remnant. Evolution of aneurysm occlusion was evaluated using a simple 3-grade scale: stable, improved, worsened.
Results: The cumulated population was 168 patients (112 females, 66.7%) with 169 aneurysms. WEB implant success was 96.4%. Mortality at discharge was 0.6% and morbidity 1.8%. At one-year (mean 12.6 months), complete aneurysm occlusion was observed in 56.0%, neck remnant in 26.0%, and aneurysm remnant in 18.0% (WEBCAST and French Observatory).
Conclusions: The analysis in this large cumulated population of studies (WEBCAST, French Observatory, WEBCAST 2) confirms great safety and efficacy of WEB treatment.