Focus of the Report: This Health Technology Assessment focuses on the use of the Woven EndoBridge (WEB) aneurysm embolization system, an intrasaccular flow disruption device, for the treatment of intracranial aneurysms (IAs).

Technology Description: The WEB aneurysm embolization system (MicroVention Inc., Terumo Group) is a permanent nickel-titanium self-expanding mesh ball implant for the treatment of wide-neck IAs located at or near branching areas of arteries in the brain. The device system features the implant, the delivery wire, and a controller that is used to detach the device from the delivery wire. The embolization system is designed to disrupt blood flow entering the aneurysm and promote clotting. After treatment, occlusion of the aneurysm is confirmed ultrasonically. Patients are treated in a hospital setting.

Controversy: While the WEB device offers a potential alternative to standard therapies for wide-necked bifurcation aneurysms, since it is designed to bridge the aneurysm neck to disrupt blood flow, the long-term efficacy and safety are unclear.

Key Questions:

  • Is the Woven EndoBridge (WEB) aneurysm embolization system effective for treatment of ruptured or unruptured intracranial aneurysms (IAs)?

  • How does WEB treatment compare with other treatments for ruptured or unruptured IAs?

  • Is WEB treatment safe for the treatment of ruptured or unruptured IAs?

  • Have definitive patient selection criteria been identified for the use of WEB treatment for ruptured or unruptured IAs?

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