作者
Laurent Spelle,Vincent Costalat,Jildaz Caroff,Fritz Wodarg,Sebastian Fischer,Denis Herbreteau,Markus Möhlenbruch,Anne‐Christine Januel,Chrysanthi Papagiannaki,Joachim Klisch,Jussi Numminen,Riitta Rautio,Ansgar Berlis,Cristian Mihalea,Vanessa Chalumeau,Jonathan Downer,Jonathan Cortese,Léon Ikka,Sophie Gallas,Maxim Bester,Thomas Liebig,Stéphane Velasco,Lamiae Grimaldi,James V. Byrne,István Szikora,Laurent Pierot,Christophe Cognard
摘要
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 To evaluate angiographic stability at 1 year. 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 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.