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

Author:

Spelle LaurentORCID,Costalat Vincent,Caroff JildazORCID,Wodarg FritzORCID,Fischer Sebastian,Herbreteau Denis,Möhlenbruch Markus A,Januel Anne-Christine,Papagiannaki ChrysanthiORCID,Klisch Joachim,Numminen Jussi,Rautio RiittaORCID,Berlis Ansgar,Mihalea CristianORCID,Chalumeau VanessaORCID,Downer JonathanORCID,Cortese Jonathan,Ikka Leon,Gallas Sophie,Bester Maxim,Liebig ThomasORCID,Velasco Stéphane,Grimaldi Lamiae,Byrne James,Szikora IstvanORCID,Pierot LaurentORCID,Cognard ChristopheORCID

Abstract

BackgroundThe 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.ObjectiveTo evaluate angiographic stability at 1 year.MethodsThe 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.ResultsAneurysm 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 aneurysmsConclusionDelivery 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.

Publisher

BMJ

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