Predicting factors of angiographic aneurysm occlusion after treatment with WEB (Woven EndoBridge) device: A single-center experience with mid-term follow-up

Background and purpose Flow disruption with WEB is increasingly used for the treatment of intracranial aneurysms. We examined factors leading to aneurysm occlusion and WEB shape change during a mid-term follow-up. Materials and methods Patients with a minimum 12-month angiographic follow-up were included. Through a univariate and multivariate analysis, independent predictors of adequate occlusion (RR1/RR2) and WEB shape change (decrease of the height of the device) were assessed. Results Eighty-six patients/aneurysms were included. The mean size was 5.5 mm (range: 3–11.5 mm). The most common locations were MCA (43/86 = 50%), BT (13/86 = 15.1%), and AcomA (12/86 = 14%). Twenty-one patients (21/86 = 24%) presented acute SAH. Immediate and long-term RR1/RR2 occlusion rates were 49% (42/86) and 80% (68/86), respectively. WEB shape change was detected among 22% (19/86) of cases. At the binary logistic regression, wide ostium (≥ 4 mm) (OR = 0.2, 95% CI = 0.01–1, P = 0.04) and regular aneurysm morphology (OR = 5.9, 95% CI = 1.4–24, P = 0.01) were independent factors of incomplete and adequate aneurysm occlusion, respectively. In addition, irregular morphology (OR = 5.4, 95% CI = 1.4–19, P = 0.01) and wide ostium (OR = 9.8, 95% CI = 1.6–60, P = 0.03) significantly increased the probability of the WEB shape change. Decrease of the WEB height was higher among incomplete occluded aneurysms (6/12 = 50% vs 13/74 = 17.5%), but it was not an independent prognosticator of occlusion at the multivariate model. Conclusions The likelihood of good occlusion was 5 times lower in the presence of a wide ostium, whereas aneurysms with regular morphology were 6 times more likely to be occluded. WEB shape modification was strongly influenced by the aneurysm shape and ostium size, and it was not independently associated with the angiographic occlusion ( Fig. 1 , Fig. 2 , Fig. 3 ).