The Woven EndoBridge Cerebral Aneurysm Embolization Device (WEB II): initial clinical experience

Abstract

The Woven Endobridge (WEB II) device (Sequent Medical, Inc., Aliso Viejo, CA, USA) is an intra-saccular, oblate, braided-wire embolization device designed to provide flow disruption at the aneurysm neck-parent artery interface. The purpose of this study was to evaluate the acute and short-term performance of the WEB II device regarding the immediacy, degree, and durability of aneurysm occlusion in two patients. The WEB II device was implanted in one patient with an unruptured MCA trifurcation aneurysm and one patient with an unruptured basilar tip aneurysm. The degree of intra-aneurysmal flow disruption was graded based on serial digital subtraction aneurysm angiography performed over 30min immediately following device implantation and at 8weeks. Immediate and 8-week post-treatment CT and 3-T MRI studies were also performed. Delivery and deployment of the WEB II device was technically straightforward and achieved without complications. Neither device required retrieval or repositioning after full deployment. There were no peri-procedural thrombembolic or hemorrhagic complications. In both cases, complete aneurysm occlusion was observed within minutes of device deployment. Short-term angiographic follow-up confirmed stable complete occlusion at 8weeks. Early technical and clinical results from the first WEB II cases have been encouraging and suggest that the intra-saccular deployment of self-expanding, compliant, cylindrical, high-density, braided metallic mesh constructs may represent a feasible approach for the endovascular treatment of cerebral aneurysms.