Long-Term Follow-up of the Woven EndoBridge (WEB) Device for the Treatment of Broad Based Intracranial Aneurysms: A Single-Center Retrospective Observational Analysis

Abstract Purpose Intracranial aneurysms are a major cause of hemorrhagic stroke, often requiring endovascular intervention. The Woven EndoBridge (WEB) device offers a minimally invasive solution for wide-neck bifurcation aneurysms and typically requires only single antiplatelet therapy, reducing bleeding risks associated with dual regimens. However, long-term clinical and angiographic data remain limited. Methods This single-center, retrospective study analyzed 247 patients treated with the WEB device between January 2013 and December 2021, with clinical and imaging follow-up through June 2024. Demographics, aneurysm characteristics, procedural outcomes, and retreatment rates were evaluated. A competing risk model was applied to identify factors associated with retreatment. Results The cohort included 247 patients (mean age: 63 years; 70% female) with 266 broad-based intracranial aneurysms. The overall retreatment rate was 12.8%, most occurring within the first year. Subgroup analysis revealed no significant differences based on aspect ratio (< 1.6 vs. ≥ 1.6) or device diameter (< 0.9 mm vs. ≥ 0.9 mm). Patients treated after 2018 had significantly lower retreatment rates (HR: 0.31; 95% CI: 0.13–0.71; p = 0.006), likely reflecting greater operator experience and introduction of the WEB17 model. Conclusion The WEB device demonstrates durable aneurysm occlusion with a low long-term retreatment rate. Improved outcomes after 2018 suggest an effect of the learning curve and device refinement. Early imaging follow-up and continued operator training remain essential to optimize procedural success.