Off-label use of WEB device effective for sidewall aneurysms
A new study published in Radiology found that mesh plugs that are traditionally used to treat brain aneurysms where the blood vessels branch out can also be effective when used to treat aneurysms on the side of the vessel.
The Terumo Woven EndoBridge (WEB) device was developed for use in wide-neck intracranial bifurcation aneurysms, but a recent analysis of its off-label use in 111 sidewall aneurysms found no significant difference in patient outcomes. So long as correct characterizations of the aneurysm location, angle, size, and morphologic characteristics are made, experts who helped conduct the study believe that the WEB device is safe for use in sidewall aneurysms.
“We found out that there is no significant difference using the WEB device in sidewall aneurysms compared with bifurcation aneurysms,” said study lead author Nimer Adeeb, M.D., from the Department of Neurosurgery and Interventional Neuroradiology at Louisiana State University in Shreveport, Louisiana. “The results show that the WEB device is safe and effective to use for sidewall aneurysms.”
The WEB device was created to overcome the limitations of the tiny plastic coils that are placed into blood vessels to treat aneurysms. If the aneurysm is wider, the coils can fall out into blood vessels, which would result in an incomplete occlusion and added risks to the patient.
“Many times, you end up putting a stent in the blood vessel to prevent the coils from falling out and to keep them compacted within the aneurysm. This can have its own complications and requires using blood thinners,” Adeeb said.
The WEB device is a braided wire intended to avoid such complications. Under angiographic guidance, it is placed inside the aneurysm. There it forms a clot that closes off the aneurysm, which, in turn, diminishes the risk of bleeding without the added use of stents or blood thinners. The device was approved by the U.S. Food and Drug Administration for use in wide-neck intracranial bifurcation aneurysms, where blood vessels branch out, but some clinicians have used it for aneurysms that occur on the side of the vessel. However, research beyond the device’s intended use has been limited.
In this study, researchers retrospectively analyzed the use of WEB devices in 683 intracranial aneurysms, of which 572 were bifurcation aneurysms, and 111 were sidewall aneurysms. Between the two groups, researchers did not note any significant differences in deployment success, complications or occlusion status on follow-up.
Experts involved in the study stated that their work could help expand the use of WEB devices into certain sidewall aneurysms. They are continuing their research efforts to involve different types and locations of aneurysms.
“Our ultimate goal is to provide our patients with the best possible treatment for their brain aneurysms,” Adeeb said.
View the detailed research in Radiology.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.