Validity of Woven EndoBridge sizing based on the device-to-aneurysm volume ratio

Area of Science:

• Neurosurgery
• Interventional Neuroradiology
• Medical Device Technology

Background:

• The Woven EndoBridge (WEB) device is a key treatment for wide-necked bifurcation intracranial aneurysms.
• Conventional sizing relies on linear measurements, often necessitating re-sizing.
• Volume-based sizing may enhance initial WEB device selection accuracy.

Purpose of the Study:

• To evaluate the efficacy of volume-based sizing for WEB device selection.
• To determine the optimal WEB-aneurysm volume (WAVe) ratio for successful initial sizing.

Main Methods:

• A multicenter retrospective cohort study included 133 patients undergoing attempted WEB embolization.
• Aneurysm and WEB volumes were measured using 3D angiogram reconstructions.
• The WEB-aneurysm volume (WAVe) ratio was calculated, and re-sizing events were recorded.

Main Results:

• 114 cases were correctly sized, while 19 required re-sizing.
• A WAVe ratio between 0.76 and 1.24 predicted >80% probability of successful initial sizing.
• Aneurysm location influenced re-sizing rates, but demographic factors did not.

Conclusions:

• Volume-based sizing, specifically the WAVe ratio, shows promise for improving initial WEB device selection.
• A WAVe ratio of 0.76-1.24 is associated with the highest likelihood of appropriate initial WEB sizing.
• Further research is needed to clarify the impact of volume-based sizing on aneurysm occlusion rates.