Lukas Goertz, Thomas Liebig, Eberhard Siebert, David Zopfs, Lenhard Pennig, Marc Schlamann, Alexandra Radomi, Franziska Dorn, Christoph Kabbasch
{"title":"Propensity Score-matched Comparison of WEB 17 and WEB 21 with 4-7 mm Device Sizes for the Treatment of Unruptured Intracranial Aneurysms.","authors":"Lukas Goertz, Thomas Liebig, Eberhard Siebert, David Zopfs, Lenhard Pennig, Marc Schlamann, Alexandra Radomi, Franziska Dorn, Christoph Kabbasch","doi":"10.1007/s00062-024-01430-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The WEB 17 system represents the fifth generation of Woven Endobridge (WEB) flow disruptors and features a low profile with fewer wires than its predecessor, the WEB 21. The present study compares the safety and efficacy of the WEB 17 and WEB 21 for the treatment of unruptured cerebral aneurysms with 4-7 mm device sizes, which were available for both systems.</p><p><strong>Methods: </strong>Patient and aneurysm characteristics, complications, clinical outcome and angiographic results were retrospectively analysed. 1:1 propensity score matching was performed to adjust for minor baseline differences between the groups.</p><p><strong>Results: </strong>Sixty aneurysms treated with WEB 21 and 90 with WEB 17 were included. The overall failure rate (deployment failure and adjunctive stent) was significantly higher with WEB 21 (16.7%) than with WEB 17 (3.3%, p < 0.01). The rates of neurological events between WEB 21 (6.7%) and WEB 17 treatment (1.1%) were not significantly different (p = 0.08). Also, procedural morbidity was comparably low in both groups (WEB 21: 3.3%, WEB 17: 0%, p = 0.16). The rates of complete/adequate occlusion at follow up were 69.7%/86.4% for WEB 17 vs. 80.4%/91.3% for WEB 21 at short-term (p = 0.27), and 64.5%/83.9% vs. 75.9%/86.2% at mid-term (p = 0.41), respectively. Propensity score matching confirmed the results of the unmatched series.</p><p><strong>Conclusion: </strong>WEB 17 and WEB 21 had a similar safety and efficacy profile, but WEB 17 was associated with an improved feasibility. Prospective studies with long-term follow-up will define the full potential of the WEB 17 system.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"841-850"},"PeriodicalIF":2.8000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564397/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00062-024-01430-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/19 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The WEB 17 system represents the fifth generation of Woven Endobridge (WEB) flow disruptors and features a low profile with fewer wires than its predecessor, the WEB 21. The present study compares the safety and efficacy of the WEB 17 and WEB 21 for the treatment of unruptured cerebral aneurysms with 4-7 mm device sizes, which were available for both systems.
Methods: Patient and aneurysm characteristics, complications, clinical outcome and angiographic results were retrospectively analysed. 1:1 propensity score matching was performed to adjust for minor baseline differences between the groups.
Results: Sixty aneurysms treated with WEB 21 and 90 with WEB 17 were included. The overall failure rate (deployment failure and adjunctive stent) was significantly higher with WEB 21 (16.7%) than with WEB 17 (3.3%, p < 0.01). The rates of neurological events between WEB 21 (6.7%) and WEB 17 treatment (1.1%) were not significantly different (p = 0.08). Also, procedural morbidity was comparably low in both groups (WEB 21: 3.3%, WEB 17: 0%, p = 0.16). The rates of complete/adequate occlusion at follow up were 69.7%/86.4% for WEB 17 vs. 80.4%/91.3% for WEB 21 at short-term (p = 0.27), and 64.5%/83.9% vs. 75.9%/86.2% at mid-term (p = 0.41), respectively. Propensity score matching confirmed the results of the unmatched series.
Conclusion: WEB 17 and WEB 21 had a similar safety and efficacy profile, but WEB 17 was associated with an improved feasibility. Prospective studies with long-term follow-up will define the full potential of the WEB 17 system.
用于治疗未破裂颅内动脉瘤的 WEB 17 和 WEB 21 与 4-7 毫米装置尺寸的倾向得分匹配比较。
目的:WEB 17系统代表了第五代编织内桥(WEB)血流阻断器,与其前身WEB 21相比,WEB 17具有外形低矮、导线较少的特点。本研究比较了 WEB 17 和 WEB 21 用于治疗未破裂脑动脉瘤的安全性和有效性,两种系统的装置尺寸均为 4-7 毫米:对患者和动脉瘤特征、并发症、临床结果和血管造影结果进行了回顾性分析。进行1:1倾向评分匹配,以调整两组间的微小基线差异:结果:60 例动脉瘤接受了 WEB 21 的治疗,90 例接受了 WEB 17 的治疗。使用 WEB 21 的总体失败率(部署失败和辅助支架)(16.7%)明显高于使用 WEB 17 的失败率(3.3%,P 结论:WEB 21 和 WEB 17 在动脉瘤治疗方面的差异很小:WEB 17 和 WEB 21 的安全性和疗效相似,但 WEB 17 的可行性更高。长期随访的前瞻性研究将确定 WEB 17 系统的全部潜力。
期刊介绍:
Clinical Neuroradiology provides current information, original contributions, and reviews in the field of neuroradiology. An interdisciplinary approach is accomplished by diagnostic and therapeutic contributions related to associated subjects.
The international coverage and relevance of the journal is underlined by its being the official journal of the German, Swiss, and Austrian Societies of Neuroradiology.