CLinical EValuation of WEB 17 device in intracranial aneuRysms (CLEVER): 1-year effectiveness results for ruptured and unruptured aneurysms.

Aneurysm Angiography Device Intervention Subarachnoid

Journal

Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079

Informations de publication

Date de publication:
11 Jul 2024
Historique:
received: 26 04 2024
accepted: 23 06 2024
medline: 12 7 2024
pubmed: 12 7 2024
entrez: 11 7 2024
Statut: aheadofprint

Résumé

The Woven EndoBridge (WEB) device is designed to treat wide-necked bifurcation aneurysms. The WEB 17 is the latest iteration and can be delivered through a 0.017″ microcatheter. The CLEVER study demonstrated that WEB 17 is safe and effective for providing protection against bleeding or rebleeding at 1 month and 1 year. To evaluate angiographic stability at 1 year. The CLEVER study was a prospective multicenter study conducted in 17 European centers, involved 163 subjects, comprising 60 ruptured and 103 unruptured aneurysms. Independent assessment of 1-year follow-up imaging was incorporated into the study design. Aneurysm diameters ranged from 2.0 to 9.2 mm, with 95.7% being broad-based (dome-to-neck ratio <2). Follow-up imaging at 1 year was completed for 146 out of 163 subjects (89.6%) and evaluated by an independent core laboratory. The primary efficacy endpoint of adequate occlusion without re-treatment at 1 year was achieved for 120 (82.2%) of all subjects. At 1 year, the adequate occlusion rate was 86.5% for ruptured aneurysms (73.1% complete occlusion) and 82.4% for unruptured aneurysms (57.1% complete occlusion). The overall re-treatment rate at 1 year was 2.6% (4/152), with 3.1% (3/97) for unruptured aneurysms and 1.8% (1/55) for ruptured aneurysms CONCLUSION: Delivery of the WEB 17 via 0.017 inch catheters represents a significant evolution of the WEB design. The results of CLEVER presented here demonstrate that it maintains the same efficacy as previous generations of WEB.

Sections du résumé

BACKGROUND BACKGROUND
The Woven EndoBridge (WEB) device is designed to treat wide-necked bifurcation aneurysms. The WEB 17 is the latest iteration and can be delivered through a 0.017″ microcatheter. The CLEVER study demonstrated that WEB 17 is safe and effective for providing protection against bleeding or rebleeding at 1 month and 1 year.
OBJECTIVE OBJECTIVE
To evaluate angiographic stability at 1 year.
METHODS METHODS
The CLEVER study was a prospective multicenter study conducted in 17 European centers, involved 163 subjects, comprising 60 ruptured and 103 unruptured aneurysms. Independent assessment of 1-year follow-up imaging was incorporated into the study design.
RESULTS RESULTS
Aneurysm diameters ranged from 2.0 to 9.2 mm, with 95.7% being broad-based (dome-to-neck ratio <2). Follow-up imaging at 1 year was completed for 146 out of 163 subjects (89.6%) and evaluated by an independent core laboratory. The primary efficacy endpoint of adequate occlusion without re-treatment at 1 year was achieved for 120 (82.2%) of all subjects. At 1 year, the adequate occlusion rate was 86.5% for ruptured aneurysms (73.1% complete occlusion) and 82.4% for unruptured aneurysms (57.1% complete occlusion). The overall re-treatment rate at 1 year was 2.6% (4/152), with 3.1% (3/97) for unruptured aneurysms and 1.8% (1/55) for ruptured aneurysms CONCLUSION: Delivery of the WEB 17 via 0.017 inch catheters represents a significant evolution of the WEB design. The results of CLEVER presented here demonstrate that it maintains the same efficacy as previous generations of WEB.

Identifiants

pubmed: 38991733
pii: jnis-2024-021918
doi: 10.1136/jnis-2024-021918
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: JCa acts as associate editor for Journal of NeuroInterventional Surgery, Neuroradiology, and Journal of Neuroradiology; MAM acts as associate editor for Neuroradiology. RR acts as associate editor for Journal of Neuroradiology.

Auteurs

Laurent Spelle (L)

NEURI The Brain Vascular Center, Interventional Neuroradiology, Bicetre Hospital, Assitance Publique - Hôpitaux de Paris, Le Kremlin-Bicetre, France laurent@spelle.fr.
Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, France.

Vincent Costalat (V)

Department of Interventional Neuroradiology, Hôpital Gui de Chauliac, Montpellier, France.

Jildaz Caroff (J)

NEURI The Brain Vascular Center, Interventional Neuroradiology, Bicetre Hospital, Assitance Publique - Hôpitaux de Paris, Le Kremlin-Bicetre, France.
Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, France.

Fritz Wodarg (F)

Department of Neuroradiology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany.

Sebastian Fischer (S)

Department of Neuroradiology, Universitätsklinikum Knappschaftskrankenhaus Bochum, Ruhr-Universität Bochum Medizinische Fakultät, Bochum, Germany.

Denis Herbreteau (D)

Department of Neuroradiology, CHU Tours, Tours, France.

Markus A Möhlenbruch (MA)

Department of Neuroradiology, UniversitatsKlinikum Heidelberg, Heidelberg, Germany.

Anne-Christine Januel (AC)

Department of Diagnostic and Therapeutic Neuroradiology, Pierre Paul Riquet Hospital, Toulouse, France.

Chrysanthi Papagiannaki (C)

Department of Interventional Neuroradiology, CHU de Rouen, Rouen, France.

Joachim Klisch (J)

Department of Neuroradiology, HELIOS Klinikum, Erfurt, Germany.

Jussi Numminen (J)

Department of Neuroradiology, Helsinki University Central Hospital, Helsinki, Finland.

Riitta Rautio (R)

Department of Radiology, Turku University Hospital, Turku, Finland.

Ansgar Berlis (A)

Department of Neuroradiology, University Hospital Augsburg, Augsburg, Germany.

Cristian Mihalea (C)

NEURI The Brain Vascular Center, Interventional Neuroradiology, Bicetre Hospital, Assitance Publique - Hôpitaux de Paris, Le Kremlin-Bicetre, France.

Vanessa Chalumeau (V)

NEURI The Brain Vascular Center, Interventional Neuroradiology, Bicetre Hospital, Assitance Publique - Hôpitaux de Paris, Le Kremlin-Bicetre, France.

Jonathan Downer (J)

Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK.
Department of Clinical Neurosciences, University of Edinburgh Division of Clinical and Surgical Sciences, Edinburgh, UK.

Jonathan Cortese (J)

NEURI The Brain Vascular Center, Interventional Neuroradiology, Bicetre Hospital, Assitance Publique - Hôpitaux de Paris, Le Kremlin-Bicetre, France.
Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, France.

Leon Ikka (L)

NEURI The Brain Vascular Center, Interventional Neuroradiology, Bicetre Hospital, Assitance Publique - Hôpitaux de Paris, Le Kremlin-Bicetre, France.

Sophie Gallas (S)

NEURI The Brain Vascular Center, Interventional Neuroradiology, Bicetre Hospital, Assitance Publique - Hôpitaux de Paris, Le Kremlin-Bicetre, France.

Maxim Bester (M)

Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Thomas Liebig (T)

Department of Neuroradiology, Ludwig-Maximilian University Hospital, Munchen, Germany.

Stéphane Velasco (S)

Department of Radiology, CHU Poitiers, Poitiers, France.

Lamiae Grimaldi (L)

Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, France.
Clinical research unit, Bicetre Hospital, Assitance Publique - Hôpitaux de Paris, Le Kremlin-Bicetre, France.

James Byrne (J)

Department of Neuroradiology, John Radcliffe Hospital, Oxford, UK.

Istvan Szikora (I)

Department of Neuroradiology, National Institute of Clinical Neurosciences, Budapest, Hungary.

Laurent Pierot (L)

Department of Neuroradiology, Maison Blanche Hospital, Reims-Champagne-Ardenne University, Reims, France.

Christophe Cognard (C)

Department of Diagnostic and Therapeutic Neuroradiology, Pierre Paul Riquet Hospital, Toulouse, France.

Classifications MeSH