O-012 Treatment of large intracranial aneurysms using the woven endobridge (WEB): a propensity score-matched analysis

Background The Woven EndoBridge (WEB) device is primarily used for treating wide-neck intracranial bifurcation aneurysms under 10 mm. Limited data exists on its efficacy for large aneurysms (≥ 10 mm). We aim to assess angiographic and clinical outcomes of the WEB device in treating large versus small aneurysms. Methods We conducted a retrospective review of the World Wide WEB Consortium database, from 2011 to 2022, across 30 academic institutions globally. Propensity score matching (PSM) was employed to compare 1331 small and 220 large aneurysms on baseline characteristics. Results A total of 1551 patients were included. Both groups were similar in age, sex, smoking status, and rupture status. Small aneurysms had higher odds of complete occlusion (2.38 times) and lower odds of retreatment (5.31 times less) than large aneurysms. After PSM, 220 matched pairs showed significantly lower occlusion rates (77.1% vs 86.6%, p = 0.0005) and higher retreatment rates (22.2% vs 3.5%, p < 0.001) in the large aneurysm group. Conclusion Large aneurysms treated with the WEB device showed lower occlusion and higher retreatment rates than small aneurysms, even after matching for baseline characteristics. These findings may inform treatment decisions and patient counseling. Disclosures B. Musmar: None. N. Adeeb: None. A. A Dmytriw: None. H. Salim: None. H. Cuellar-Saenz: None. P. Jabbour: None.