ArticleNeuroradiology2026
Optimal device-to-aneurysm ratio and one-year radiological outcomes of volume-based woven endobridge selection.
Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe woven EndoBridge (WEB) device has been introduced for the treatment of wide-neck bifurcation aneurysms; however, device selection remains a major challenge inWEB treatment. This study aimed to demonstrate the effectiveness of WEB selection using volumetric analysis and its 1-year radiological outcomes.
methodsWe retrospectively analysed patients with unruptured wide-neck bifurcation aneurysms who underwent WEB treatment between August 2021 and January 2023. Aneurysm volume was measured semi-automatically using a three-dimensional volume-rendering programme. Radiological outcomes were analysed using the WEB Occlusion Scale (WOS) at 1-year catheter angiography follow-up. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the prognostic performance of the device-to-aneurysm volume (DAV) ratio for predicting complete occlusion. Univariate and multivariate analyses were performed to assess the predictive factors for complete occlusion.
resultsFifty-seven unruptured intracranial aneurysms, in 56 patients were treated with the WEB device. The device was changed in 14 patients (24.6%) following the + 1/-1 rule, and volume-based recommendations were appropriate for all patients. At the 1-year follow-up, complete occlusion (WOS A and B) was confirmed in 35 patients (61.4%), and adequate occlusion (WOS A, B, and C) was confirmed in 87.7% (50 of 57 patients). The ROC curve analysis showed a significant relationship for 1-year complete occlusion (area under the curve: 0.74, 95% confidence interval [CI]: 0.59-0.88) with an optimal cut-off of 0.92. The DAV ratio was the only significant predictive factor for 1-year complete occlusion in the univariate (odds ratio [OR]: 7.0, 95% CI: 2.20-24.7, p = 0.001) and multivariate (OR: 20.39, 95% CI: 3.56-111.73, p = 0.0007) analyses.
conclusionsVolume-based WEB selection was appropriate for initial device selection and 1-year radiological outcomes. The selection of a WEB device with a volume exceeding 92% of that of the targeted aneurysm could be considered for 1-year radiological outcomes.
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