E-222 Web colombian multicenter experience (WEB.COM): clinical and radiological mid- long term results in the treatment of intracranial aneurysms using intrasaccular flow disrupters

2020 
Introduction Woven EndoBridge (WEB) is a novel device for the treatment of ruptured and unruptured bifurcation aneurysms. To our knowledge none experience in Latin America has been reported. Here, we present a multi-center experience including mid and long-term follow data of patients treated with WEB. Materials and Methods Consecutive patients treated with WEB were selected from March 2016 to February 2020 in six different centers in our country. We retrospectively evaluated clinical records, anatomical and angiographic variables. Additionally, WEB technical aspects, Procedure time and the presence of adverse events procedure-related were registered. Immediately angiographic results and mid, long term- follow up were analyzed and described below. Results 73 patients (mean age: 52.8) with 75 IA were treated with WEB. History of SAH in 16/75(21%). A total of 84 devices attempted and finally implanted 75 (1.1 device per aneurysm) of these, eight devices were exchanged due to sizing failures, one case of WEB miss-opening was discharged. 59/75 (78.6%) were located in anterior circulation (MCA: 32, ACA: 19, ICA: 8). Sixteen cases in posterior circulation (Basilar tip: 13, SCA: 2, VBJ: 1). An additional strategy was observed in five cases (6.6%): high porosity stent in four and balloon assisted web in one case. WEB SL was used in 82.6% and WEB SLS configuration in 13/75. Radiological follow up available 6–12 moths in 49/73 (67%) with adequate occlusion rate according to WOS in 86.6%. None thromboembolic complications. Two patients with severe hemorrhages procedure-related (one case of ICA rupture due to DAC advancement, and one wire- perforation of tip- basilar aneurysm). Overall morbid-mortality of 2.6%. Conclusion In this multicenter experience the treatment of IA using WEB was feasible, safe and effective. Overall morbid-mortality (2.6%) aligned with previous publications. Special care regarding sizing methodology and proper training to reach an accurate and fast learning curve should be considered. This technology constitutes a good and valuable tool to treat bifurcation IA´s but also is on the way to be applied in different scenarios than WNBA in highly selected patients. Disclosures B. Pabon: None. M. Patino: None. O. Vargas: None. V. Torres: None. J. Gutierrez: None. J. Fernandez: None. R. Alemeida: None. F. Orozco: None. N. Lobelo: None. M. Fonseca: None. A. Pedroza: None. W. Escobar: None.
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