Safety and Efficacy of the Woven EndoBridge Device for Treatment of Ruptured Intracranial Aneurysms: A Systematic Review and Meta-analysis.

Abstract

The Woven EndoBridge device has been increasingly used to treat wide-neck aneurysms, particularly ruptured ones. Our aim was to investigate the safety and efficacy of the Woven EndoBridge device in the treatment of ruptured intracranial aneurysms. All studies evaluating the outcomes of Woven EndoBridge device use in the treatment of ruptured intracranial aneurysms from inception through 2020 were searched on Ovid Evidence-Based Medicine Reviews, EMBASE, MEDLINE, Scopus, and the Web of Science Core Collection. Eighteen studies encompassing 487 patients with 496 ruptured aneurysms treated with the Woven EndoBridge device were included. We studied rates of rerupture and retreatment, angiographic outcomes at the last follow-up point, complications, and mortality rates. Data were collected on anticoagulation and antiplatelet use. Meta-analysis was performed using the random effects model. The rate of late rebleeding was 1.1% (95% CI, 0.1%-2.1%). The treatment-related perioperative complication rate and the overall clinical complication rate were 13.2% (95% CI, 9.2%-17.2%) and 3.2% (95% CI, 1.6%-4.7%), respectively. Thirteen hemorrhagic (2%; 95% CI, 0.8%-3.3%) and 41 thromboembolic (6.8%; 95% CI, 4.6%-9%) complications occurred. Favorable clinical outcomes were achieved in 85% of patients. Procedure-related mortality and overall mortality rates were 2.1% (95% CI, 0.8%-3.3%) and 11.5% (95% CI, 7%-16%), respectively. At last follow-up, an adequate occlusion rate was 87.3% (95% CI, 82.1%-92.4%) and the retreatment rate was 5.1% (95% CI, 3%-7.3%). Our meta-analysis is limited by selection bias and high heterogeneity. This meta-analysis demonstrated the safety and efficacy of the Woven EndoBridge device in the management of ruptured aneurysms, but further studies are needed.