Systematic review of WEBectomy in intracranial aneurysms

PurposeEndovascular removal of the Woven EndoBridge device (WEBectomy) is rarely reported but crucial for managing complications such as migration, compaction, and malposition, which may lead to recurrence and retreatment. This review aimed to assess treatment strategies, outcomes, and complications associated with WEBectomy.MethodsWe searched PubMed, Embase, and Web of Science databases from inception to January 14,2025,following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies reporting on cases of WEBectomy.ResultsEight studies with 16 patients (range age 30-89; 50% male) with 16 aneurysms were included. The basilar artery was the most common site in 25% (4/16) of the cases, and 50% (7/14) of the aneurysms were ruptured. Migration was the most frequent complication (11/16, 69%), followed by protrusion (4/16, 25%) and malposition (1/16, 6%) that required the removal of WEB. The Amplatz Goose Neck Microsnare was the most commonly used retrieval device (12/16, 75%), with no reported failures or major complications. Retreatment involved a new WEB in 50% (8/16) and coiling techniques in 31% (5/16). Among nine patients with follow-up imaging, most showed complete occlusion (67%, 6/9). Functional outcomes were favorable in 83% (4/6) (mRS 0-1).ConclusionReported cases show that WEBectomy can be successfully performed in selected situations, allowing tailored retreatment planning. However, due to the small number of cases and limited follow-up, no definitive conclusions about safety or efficacy can be drawn. This review provides a concise synthesis of current management strategies for this rare complication.