A prospective multicenter study reports that Woven EndoBridge intrasaccular therapy safely and effectively treats unruptured wide-necked bifurcation aneurysms, one of the most challenging brain aneurysm types to manage. The trial found high occlusion stability, low complication rates, and no retreatments or deaths at one year of follow-up. The findings support this minimally invasive option as a promising alternative to conventional techniques and expand evidence supporting its safe and effective use in a Chinese patient population.
Brain aneurysms are balloon-like bulges in blood vessels that can rupture, causing life-threatening hemorrhages. Wide-necked bifurcation aneurysms (WNBAs), occurring at arterial branch points, are particularly challenging to treat due to their complex anatomy. Conventional coiling or stent-assisted techniques may require long-term blood-thinning therapy and carry risks of thromboembolism or vessel damage. Seeking safer, less invasive options, researchers investigated the Woven EndoBridge (WEB) intrasaccular device, designed to sit entirely inside the aneurysm, disrupt blood flow, and promote clot formation without extending into the parent artery.
A research team led by Professor Hongqi Zhang from the Department of Neurosurgery at Xuanwu Hospital, Capital Medical University, Beijing, China and Professor Jianmin Liu from Neurovascular Center, Naval Medical University, Changhai Hospital, Shanghai, China, conducted a prospective multicenter observational study across eight Chinese hospitals between June 2017 and August 2019. The study enrolled 60 adult patients with unruptured WNBAs suitable for WEB implantation. Each patient underwent standardized imaging, procedural planning, and follow-up at 30 days, 6 months, and 1 year. The study was published in Volume 12 of the Chinese Neurosurgical Journal on January 20.
The WEB device, a braided nitinol mesh, was implanted using microcatheters and detached within the aneurysm sac. Its design may reduce reliance on dual antiplatelet therapy and the risk of thromboembolic complications compared with techniques requiring permanent intravascular implants. Procedural success was achieved in 98% of cases. At one-year follow-up, complete aneurysm occlusion was observed in 56% of patients, with adequate occlusion in 82%. No patients required retreatment, experienced aneurysm rupture, or died. Major adverse events occurred in only two patients (3.9%), both unrelated to the device. Functional independence remained high throughout follow-up.
"These findings suggest that intrasaccular flow disruption can provide durable aneurysm occlusion rupture while minimizing risks associated with traditional techniques," said Prof. Zhang. The study demonstrates that the WEB device can safely seal complex aneurysms with a high degree of stability over time.
Beyond individual patient benefits, the findings support broader evaluation and adoption of minimally invasive intrasaccular techniques for complex aneurysms. Prof. Liu added: "Our results demonstrate that advanced endovascular technologies can be safely adopted across diverse populations, paving the way for international collaboration and future device innovation." While further research is needed with larger cohorts and longer follow-up periods, this study confirms that WEB provides a reliable alternative to conventional treatments for WNBAs.
