Impact of Woven EndoBridge (WEB) device protrusion on postprocedural diffusion-weighted imaging lesions
Gregor Peter1, Luca Meucci2, Vincent Geest2
1Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany g.peter@uke.de.
Background:
To evaluate the impact of Woven EndoBridge (WEB) device protrusion on the occurrence and number of postprocedural diffusion-weighted imaging (DWI) lesions in patients with unruptured intracranial aneurysms.
Methods:
This retrospective single-center study included all consecutive patients with unruptured intracranial aneurysms treated with the WEB device between January 2019 and May 2026. Postprocedural brain MRI, including DWI, was performed within 24-72 hours after treatment. The presence and number of postprocedural DWI lesions, as well as the WEB protrusion, were independently assessed by two experienced board-certified neuroradiologists. Univariable and multivariable linear regression analyses were performed to identify factors associated with the number of postprocedural DWI lesions. Logistic regression analyses were used to assess factors associated with the occurrence of DWI lesions.
Results:
WEB protrusion was observed in 26/117 patients (22%). Postprocedural DWI lesions occurred in 51/117 patients (44%), without a significant difference between patients with and without protrusion (13/26 (50%) vs 38/91 (42%), P=0.408). However, the mean number of postprocedural DWI lesions was significantly higher in patients with WEB protrusion compared with those without protrusion (4.6±10.2 vs 1.5±3.2, P=0.013). In the multivariable linear regression model, only WEB protrusion was significantly associated with the number of postprocedural DWI lesions (β=3.03 (0.49-5.57), P=0.02).
Conclusion:
WEB protrusion was independently associated with the number of DWI lesions after treatment of unruptured intracranial aneurysms. In contrast, procedure duration was associated with DWI lesion occurrence, whereas repositioning attempts showed no independent association with either lesion occurrence or lesion burden.
