Tehran University of Medical Sciences

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Comparison of Woven Endobridge and Stent-Assisted Coiling for Treatment of Acutely Ruptured Wide-Neck Bifurcation Aneurysms: Single-Center Experience Publisher



Ghanaati H1 ; Rahmatian A2, 3 ; Torkaman A3 ; Dashtkoohi M3, 4 ; Ohadi MAD4
Authors
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Authors Affiliations
  1. 1. Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Emam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Neurology, Ilam University of Medical Sciences, Ilam, Iran
  3. 3. Iranian Center of Neurological Research, Department of Neurovascular Intervention, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Cerebrovascular and Endovascular Neurosurgery Published:2025


Abstract

Objective: Treating wide-necked bifurcation aneurysms (WNBA) is challenging. Nevertheless, recent progress in endovascular techniques is promising. Woven EndoBridge devices (WEB) have exhibited outcomes comparable to conventional treatments like stent-assisted coiling (SAC) in treating aneurysms. However, their safety and efficacy in managing acutely ruptured aneurysms remain a topic of interest. This study focuses on this issue. Methods: We searched our database from 2020 to 2023 and found 38 patients with acutely (< a week) ruptured WNBA. We extracted radiologic and clinical data from the available medical reports. Favorable functional and radiologic outcomes were assessed using the modified Rankin scale (mRS) and modified Raymond–Roy occlusion classification (MRRC). Results: Our study population comprised 15 aneurysms treated with WEB and 25 treated with SAC. Operational time was significantly lower in the WEB compared to the SAC group (39.3 vs 66.2 minutes, p value: < 0.001). Immediate (p value=0.64) and the 18th-month (p value=0.42) occlusion rates were comparable between the two groups. Favorable mRS scores in the 3rd month were seen in 100% of SAC patients and 93.3% of WEB patients (p value=0.79). Retreatment (p value=1.0) and complication (p value=0.39) rates were comparable. Vasospasms after the procedure were the most common complication. Conclusions: WEB demonstrated comparable safety and efficacy to SAC in patients with acutely ruptured WNBA. Notably, WEB had a shorter procedure duration. Additional studies with extended follow-up periods are necessary for comprehensive evaluation. © 2025 by KSCVS and KoNES.
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