Off-Label Use of the WEB Device.

Area of Science:

• Neurosurgery
• Interventional Neuroradiology
• Vascular Neurology

Background:

• Intracranial aneurysms pose significant risks, often requiring complex treatment strategies.
• The Woven EndoBridge (WEB) device is an endovascular implant used for aneurysm treatment.
• Off-label use of devices necessitates careful evaluation of safety and efficacy.

Purpose of the Study:

• To evaluate the initial experience with the off-label use of the Woven EndoBridge (WEB) device for intracranial aneurysms.
• To assess the feasibility, safety, and preliminary outcomes of WEB device deployment in non-standard anatomical locations.

Main Methods:

• Retrospective study involving 11 patients with 12 intracranial aneurysms treated at two institutions.
• WEB device used alone or with adjuncts (stenting/coiling) in off-label locations.
• Analysis of procedural details, aneurysm characteristics, and post-procedural occlusion using the O'Kelly-Marotta (OKM) grading scale.

Main Results:

• Successful WEB device deployment in various off-label locations, including posterior communicating artery and ophthalmic artery aneurysms.
• Four aneurysms (30.8%) were ruptured; no procedure-related deaths or symptomatic complications reported.
• Adequate or complete occlusion achieved in all patients (66.6% adequate, 33.3% complete).

Conclusions:

• The Woven EndoBridge (WEB) device can be safely and effectively deployed in off-label intracranial aneurysm locations.
• Careful patient and aneurysm selection, along with awareness of adjunct treatments, are critical for successful outcomes.
• Further multicenter prospective studies are needed to confirm the efficacy of off-label WEB device use.