SynthesisMedicine2026
Woven endobridge device compared to stent-assisted coiling and microsurgical clipping for intracranial aneurysms: A systematic review and meta-analysis.
Synthesis in Medicine, 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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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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11 authors.
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Abstract
backgroundEndovascular techniques and devices, including Woven EndoBridge (WEB) and stent-assisted coiling (SAC), expand the choice of therapies for complex aneurysms, while the evidence directly comparing them to microsurgical clipping (MSC) remains very limited. This meta-analysis compares the safety and efficacy of WEB vs SAC and MSC in patients with ruptured and unruptured intracranial aneurysms.
methodsThis study followed PRISMA guidelines. A comprehensive search of PubMed, Embase, and Scopus identified comparative cohort studies of WEB vs SAC and MSC for wide-neck intracranial aneurysms. Outcomes included occlusion, favorable functional/neurological outcome, defined as a modified Rankin Scale (mRS) score of 0-2, complications, and mortality. Statistical analyses were performed in R Studio. Heterogeneity was assessed with I2 and leave-one-out (LOO) sensitivity, and publication bias with funnel plots and Egger's test.
resultsSeventeen observational studies with a total of 2289 patients were included. When compared with mechanical circulatory support (MSC), the WEB device was associated with lower rates of adequate occlusion (RR 0.77; 95% CI 0.69-0.86; P < .001) and higher rates of incomplete occlusion (RR 4.61; 95% CI 2.12-10.01; P < .001). No significant differences were found in mortality or favorable neurological outcomes (defined as modified Rankin Scale [mRS] 0-2). In comparisons with stent-assisted coiling (SAC), the WEB device showed similar rates of complete occlusion (RR 0.98; P = .617), retreatment (RR 0.79; P = .508), and thromboembolic complications (RR 0.59; P = .137). The WEB device did demonstrate a significantly lower incidence of procedure-related complications (RR 0.49; 95% CI 0.29-0.85; P = .011).
conclusionMSC offers the most durable occlusion, whereas WEB and SAC are less invasive, with WEB showing better safety than SAC but lower durability than MSC, supporting individualized, evidence-based treatment.
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