Evidence map›Paper›PMID 42711440›Full record

ArticleEuropean radiology2026

Smaller WEB devices show lower retreatment rates than larger devices: results from the WorldWideWEB study.

Franja Dugar, Hamza Adel Salim, Basel Musmar, Nimer Adeeb, Mahmoud Dibas, Davide Simonato, Yan-Lin Li, Muhammed Amir Essibayi, Oktay Algin, Sherief Ghozy and 76 more

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Article in European radiology, 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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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

86 authors.

Franja DugarDepartment of Radiology, Neuroradiology and Nuclear Medicine, Stadtspital Zurich, Zurich, Switzerland.
Hamza Adel SalimDepartment of Neuroradiology, MD Anderson Medical Center, Houston, TX, USA.
Basel MusmarDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA.
Nimer AdeebDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA.
Mahmoud DibasDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA.
Davide SimonatoDepartment of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Yan-Lin LiDepartment of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Muhammed Amir EssibayiDepartment of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Oktay AlginDepartment of Radiology, Medical Faculty of Ankara University, Ankara, Turkey.
Sherief GhozyDepartments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA.
Sovann V LayDepartment of Neuroradiology, Centre Hospitalier de Toulouse, Toulouse, France.
Adrien GuenegoDepartment of Neuroradiology, Hôpital Universitaire Erasme, Bruxelles, Belgium.
Leonardo RenieriDepartment of Neuroradiology, Ospedale Careggi di Firenze, Florence, Italy.
Joseph CarnevaleDepartment of Neurosurgery and Neuroradiology, New York Presbyterian Hospital and Weill Cornell School of Medicine, New York, NY, USA.
Guillaume SaliouDepartment of Neuroradiology, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland.
Panagiotis MastorakosDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Eimad ShotarDepartment of Neuroradiology, Hôpital Pitié-Salpêtrière, Paris, France.
Markus MöhlenbruchDepartment of Neuroradiology, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Michael KralDepartment of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria.
Charlotte ChungDepartments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA.
Mohamed M SalemDepartment of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA.
Ivan LylykDepartment of Neuroradiology, Clínica La Sagrada Familia, Buenos Aires, Argentina.
Paul M ForemanDepartment of Neurosurgery, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA.
Hamza ShaikhDepartment of Neuroradiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia.
Vedran ŽupančićDepartment of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA.
Muhammad U HafeezDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
Joshua CatapanoDepartment of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
Muhammad WaqasDepartment of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
Ahmet Gurhan GurcayDepartment of Neurosurgery, Yildirim Beyazit University, Ankara, Turkey.
Giyas AyberkDepartment of Neurosurgery, Yildirim Beyazit University, Ankara, Turkey.
Muhammet ArslanDepartment of Neurosurgery, Yildirim Beyazit University, Ankara, Turkey.
James D RabinovNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Onur ErgunNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Julian MaingardDepartment of Neuroradiology, Austin Health, Heidelberg, VIC, Australia.
Clemens M SchirmerDepartment of Neurosurgery and Radiology, Geisinger Hospital, Danville, PA, USA.
Mariangela PianoDepartment of Neuroradiology, Ospedale Niguarda Cà Granda, Milano, Italy.
Anna L KühnDepartment of Neuroradiology, UMass Memorial Hospital, Worcester, MA, USA.
Caterina MichelozziDepartment of Neuroradiology, Ospedale San Raffaele, Milano, Italy.
Robert M StarkeDepartment of Neurosurgery, University of Miami, Miami, FL, USA.
Ameer HassanDepartment of Neuroradiology, Valley Baptist Neuroscience Institute, Harlingen, TX, USA.
Mark OgilvieDepartments of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Jesse JonesDepartments of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Waleed BrinjikjiDepartments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA.
Marios PsychogiosDepartment of Neuroradiology, University Hospital of Basel, Basel, Switzerland.
Marie T NawkaDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
Jens FiehlerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
Thi Dan Linh Nguyen-KimDepartment of Radiology, Neuroradiology and Nuclear Medicine, Stadtspital Zurich, Zurich, Switzerland.
Bryan PukenasDepartment of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA.
Jan-Karl BurkhardtDepartment of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA.
Thien HuynhDepartments of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Juan Carlos Martinez-GutierrezDepartment of Neuroradiology, University of Texas Health Science Center at Houston, Houston, TX, USA.
Sunil A ShethDepartment of Neuroradiology, University of Texas Health Science Center at Houston, Houston, TX, USA.
Diana SlawskiDepartment of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, CA, USA.
Rabih G TawkDepartments of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Benjamin PulliDepartment of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, CA, USA.
Boris LubiczDepartment of Neuroradiology, Hôpital Universitaire Erasme, Bruxelles, Belgium.
Pietro PanniDepartment of Neuroradiology, Ospedale San Raffaele, Milano, Italy.
Ajit S PuriDepartment of Neuroradiology, UMass Memorial Hospital, Worcester, MA, USA.
Guglielmo PeroDepartment of Neuroradiology, Ospedale Niguarda Cà Granda, Milano, Italy.
Eytan RazDepartments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA.
Christoph J GriessenauerDepartment of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria.
Hamed AsadiDepartments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA.
Adnan SiddiquiDepartment of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
Elad I LevyDepartment of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
Neil HaranhalliDepartment of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
David AltschulDepartment of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Andrew F DucruetDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
Robert W RegenhardtNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Christopher J StapletonNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Peter KanDepartment of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA.
Vladimir KalousekDepartment of Neuroradiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia.
Pedro LylykDepartment of Neuroradiology, Clínica La Sagrada Familia, Buenos Aires, Argentina.
Srikanth BodduDepartment of Neurosurgery and Neuroradiology, New York Presbyterian Hospital and Weill Cornell School of Medicine, New York, NY, USA.
Jared KnopmanDepartment of Neuroradiology, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland.
Stavropoula I TjoumakarisDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Hugo H Cuellar-SaenzDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA.
Pascal M JabbourDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Frédéric ClarençonDepartment of Neuroradiology, Hôpital Pitié-Salpêtrière, Paris, France.
Nicola LimbucciDepartment of Neurosurgery and Neuroradiology, New York Presbyterian Hospital and Weill Cornell School of Medicine, New York, NY, USA.
Maurizio FuschiDepartment of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Aman B PatelNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Mohammad AlmohammadDepartment of Neuroradiology, University Hospital Marburg, Marburg, Germany.
Andre KemmlingDepartment of Neuroradiology, University Hospital Marburg, Marburg, Germany.
Adam A Dmytriw *Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, USA.
Peter B Sporns *Department of Radiology, Neuroradiology and Nuclear Medicine, Stadtspital Zurich, Zurich, Switzerland. peter.sporns@hotmail.de.ORCID http://orcid.org/0000-0002-3028-0539
WorldWideWEB Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesSmall Woven EndoBridge (WEB) devices (≤ 4.5 mm) for the intracranial aneurysm treatment are technically challenging to deploy, with limited efficacy and safety data. This study compared functional, angiographic, and safety outcomes of small WEBs with large (> 4.5 mm) and very large (> 7.5 mm) WEBs. MATERIALS AND

methodsThe WorldWideWEB consortium is a retrospective, multicenter collaboration across 30 international institutions including adults with intracranial aneurysms treated with WEB. Patients were stratified into small (≤ 4.5 mm) and large (> 4.5 mm) groups; a subanalysis compared small with very large (> 7.5 mm) devices. Primary outcome was retreatment rate. Secondary outcomes included modified Rankin Scale (mRS), angiographic outcomes periprocedurally and last follow-up (FU), and safety events (intracranial hemorrhage (ICH) and thromboembolic complications (TECs)).

resultsAmong 1473 patients, 229 (15.5%) received small WEBs. Baseline characteristics were similar. Small WEBs showed lower retreatment (4.3% vs 8.8%, p = 0.04) and higher complete occlusion (periprocedurally: 57.1% vs 36.6%, p < 0.01; FU: 76.2% vs 58.5%, p < 0.01). Median mRS was comparable (1 [1-2] vs 1 [1-2], p = 0.88), as was safety (ICH 2.6% vs 0.9%, p = 0.10; TECs 3.1% vs 3.9%, p = 0.69). Very large WEBs had higher retreatment (16.1%, p < 0.001) and lower complete occlusion (periprocedurally: 32.2%, p < 0.001; FU: 50.5%, p < 0.001), with comparable safety (ICH 0.9%, p = 0.27; TECs 4.5%, p = 0.51).

conclusionSmall WEBs demonstrated lower retreatment, superior anatomic and comparable clinical outcomes compared with large devices, with similar safety profiles. KEY POINTS: Question Do small Woven EndoBridge devices have comparable efficacy and safety to larger devices for intracranial aneurysm treatment despite technical deployment challenges? Findings Small Woven EndoBridge devices (≤ 4.5 mm) achieved lower retreatment rates and superior angiographic occlusion compared with larger devices, with similar safety and functional outcomes. Clinical relevance These findings support the use of small Woven EndoBridge devices for appropriately sized aneurysms, providing reassurance that deployment challenges do not translate into worse clinical outcomes, while superior anatomic outcomes may encourage their broader adoption in clinical practice.

Indexed as

Device sizeEndovascular treatmentIntracranial aneurysmWoven EndoBridge (WEB)

Identifiers

PMID42711440

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