Rebleeding, retreatment, and 1-year occlusion rate after WEB treatment of ruptured intracranial aneurysms: comparison of the WEB-21 vs WEB-17 systems

Background
Endovascular treatment of intracranial aneurysms has significantly advanced, with the Woven EndoBridge (WEB) device emerging as a promising option for wide-necked aneurysms. The latest iteration, WEB-17, allows for delivery through a smaller microcatheter but has a reduced number of wires in comparison with the previous WEB-21 system.

Objective
To evaluate the safety and efficacy of WEB-17 in ruptured aneurysms.

Methods
A retrospectively analyzed single-center study of a prospectively maintained registry including 200 patients with ruptured intracranial aneurysms treated with either the WEB-21 or WEB-17 system. Procedural complications, including rebleeding and vasospasm, were analyzed and compared between the two cohorts. Postoperative follow-up assessed aneurysm occlusion rates and clinical outcomes.

Results
The WEB-17 system was used in 65% of cases, while WEB-21 was used in 35%. No significant differences were found in baseline patient characteristics. In addition, no significant differences were found between periprocedural complications, aneurysmal rebleeds, and delayed cortical ischemia. However, there were more aneurysm remnants and more retreatments with the WEB-17.Conclusion Both WEB systems demonstrated good safety and efficacy in the treatment of ruptured intracranial aneurysms. The WEB-17 system, however, demonstrated significantly lower complete occlusion rates and a trend towards increased retreatment rates. Further studies are required to confirm long-term outcomes or to detect smaller group differences.