University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository




Prof Larry Herman, DMSc, MPA, PA-C, DFAAPA



Background and Purpose: Treatment of intracranial aneurysms has evolved and much like other advancements in technology, there has been an exponential change in the last 30 years. The purpose of this article is to review the use of the Woven EndoBridge (WEB) device for endovascular treatment of Wide-Neck Bifurcation Aneurysms (WNBA). This literature review intends to promulgate the advantages of this new technology in the treatment of WNBAs.

Methods: A PubMed literature search was conducted with search terms Woven EndoBridge, wide-neck bifurcation aneurysm, aneurysm treatment, and endovascular aneurysm treatment in various combinations. Filters were used for each search limiting results to literature in the past six years and placing emphasis on the hierarchy of study design, resulting in 30 pertinent articles to serve as the basis for this clinical review. Eight final articles were chosen for review and have been included in this paper.

Results: There is consistent evidence to suggest the safety and efficacy of the WEB device is a viable option for the treatment of WNBA. Large-scale randomized clinical trials have not been performed to fully evaluate the WEB device vs conventional treatment strategies for WNBA however, the case series reviewed appear to show that this device is comparable. Further, there is evidence to suggest the benefit of using the WEB device in the setting of ruptured WNBA that may decrease the risks in this patient population.

Conclusion: The use of the WEB device has been shown safe and efficacious in the treatment of ruptured and unruptured WNBAs in a single procedure. Further, the use of the WEB device for ruptured WNBAs provides a useful alternative to open craniotomy and clipping; and eliminates the need for DAPT before stent-assisted procedures in this delicate patient population. Although the initial results are promising, further prospective, randomized trials comparing WEB with conventional therapies are needed.


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