Long-term outcomes of the Woven EndoBridge device for intracranial aneurysms: systematic review and meta-analysis

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.