Long-term outcomes of the Woven EndoBridge device for intracranial aneurysms: systematic review and meta-analysis
Clinical Snapshot
PICO Framework
| P — Population | Patients with intracranial aneurysms (both ruptured and unruptured) treated with WEB device |
| I — Intervention | Woven EndoBridge (WEB) device treatment |
| C — Comparator | No specific comparator (single-arm meta-analysis) |
| O — Outcomes | Long-term (≥1 year) adequate occlusion rates, retreatment rates, adverse events, delayed rupture, rebleeding |
Bottom Line
This comprehensive meta-analysis of 1735 patients demonstrates that the Woven EndoBridge device provides excellent long-term outcomes for intracranial aneurysm treatment, with adequate occlusion rates consistently above 87% at all time points up to 5 years. The low retreatment rate of 7.2% and absence of delayed rupture or device-related adverse events beyond one year support its safety profile. These findings are particularly relevant for Australian neurointerventional practice, where the WEB device represents a valuable treatment option for both ruptured and unruptured aneurysms. However, clinicians should note the lack of comparative data with other treatment modalities and the potential for selection bias in the included studies. The evidence strongly supports the WEB device as a reliable first-line endovascular treatment for appropriately selected intracranial aneurysms.
Key Findings
P Value: Not reported in abstract
Effect Size: 87.3% to 93.3% adequate occlusion rates across time points
Primary Outcome: Adequate occlusion rates at long-term follow-up
Nnt Or Sensitivity: Retreatment rate 7.2% (95% CI 4.8% to 9.6%); no delayed rupture or rebleeding events
Confidence Interval: 95% CI ranges from 80.5% to 99.0% depending on time point
Clinical Application
Requires specialised neurointerventional expertise and appropriate imaging follow-up protocols Relevant to Australian neurointerventional practice; WEB device likely available through TGA approval for endovascular aneurysm treatment in tertiary centres Patients with both ruptured and unruptured intracranial aneurysms suitable for endovascular treatment
Abstract
BACKGROUND: The Woven EndoBridge (WEB) device is widely recognized as a safe and effective treatment for intracranial aneurysms (IAs). However, data on the long-term evolution of aneurysm occlusion remain limited. This meta-analysis evaluates the long-term (≥1 year) safety and efficacy outcomes of patients treated with the WEB device. METHODS: A comprehensive literature search was conducted in PubMed, Web of Science, and Scopus for studies published between January 1, 2011 and August 1, 2024 following PRISMA guidelines. Studies reporting outcome for IAs treated with the WEB device and a follow-up period of ≥1 year were included. Data were pooled using a random-effects model to account for variability across studies. RESULTS: A total of 25 studies including 1735 patients and 1768 aneurysms were analyzed (30.1% ruptured). The pooled adequate occlusion rates were 87.3% (95% CI 83.5% to 91.1%) at 1 year, 90.7% (95% CI 86.2% to 95.2%) at 1-2 years, 93.3% (95% CI 87.7% to 99.0%) at 3 years, and 88.4% (95% CI 80.5% to 96.4%) at 5 years. Adequate occlusion was achieved in 89.2% (95% CI 83.0% to 93.2%) of unruptured aneurysms and 85.9% (95% CI 80.2% to 90.1%) of ruptured aneurysms. The overall retreatment rate at the last long-term follow-up was 7.2% (95% CI 4.8% to 9.6%). No procedure- or device-related adverse events were reported beyond 1-year follow-up. Additionally, no cases of delayed rupture or aneurysm rebleeding were observed. CONCLUSION: This systematic review and meta-analysis confirms the high long-term efficacy and safety of the WEB device in treating both ruptured and unruptured aneurysms. The findings support the WEB device as a reliable and effective treatment option for IAs.
References
- 1.Palmisano, V., Ganimede, M. P., Diana, F., Lozupone, E., Di Stasi, C., Burdi, N., & Semeraro, V. (2026). Long-term outcomes of the Woven EndoBridge device for intracranial aneurysms: systematic review and meta-analysis. Journal of Neurointerventional Surgery. https://doi.org/10.1136/jnis-2025-023799
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