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Purpose Conventional Woven EndoBridge (WEB) device sizing is primarily based on aneurysm measurements of the width and height, which may lead to suboptimal device selection and procedural difficulties. This study aimed to retrospectively evaluate WEB device sizing using the device-aneurysm volume (DAV) ratio with the MP Neuro TM volumetric measurement program and to assess alternative device sizes with the DAV ratio.Methods A retrospective, single-center study was conducted between September 2021 and June 2025. Patient demographics, aneurysm characteristics were analyzed. Aneurysm volume was calculated using the MP Neuro TM measurement program, and the DAV ratio was determined for the implanted device and for potential alternative device sizes. We further reviewed sizing related procedural difficulties including device exchange, adjunctive stent placement and device protrusion into the parent artery.Results During the study period, 32 unruptured aneurysm cases were treated with the WEB device. One case was excluded due to unavailable volumetric data, leaving 31 cases for analysis. Sizing related procedural difficulties occurred in 7 cases (22.5%) all of which were due to initial oversizing. These difficulties consisted of device exchange in 5 cases, adjunctive stent deployment in 1 case and protrusion into the parent artery in 1 case. Among the device exchange cases, 4 cases were successfully resolved after device exchange, whereas 1 case resulted in undersizing. Overall, 28 cases (90.3%) were successfully treated without persistent procedural difficulties. The overall mean DAV ratio of the implanted device was 1.13 ± 0.16 (range, 0.68-1.45). The mean DAV ratio in technically successful cases without persistent procedural difficulties was 1.13 ± 0.14 (range, 0.89-1.45). Cases with sizing-related procedural difficulties had a higher mean DAV ratio of 1.30 ± 0.22 (range, 1.09-1.73). Statistical analysis revealed that aneurysm width was significantly larger in cases with sizing-related procedural difficulties (p=0.043). The DAV ratio tended to be higher in the sizing-related procedural difficulty group, although the difference did not reach statistical significance (p=0.060)Conclusions Retrospective volumetric reassessment using the MP Neuro TM measurement program suggests that device-aneurysm volume ratio-based analysis may help identify optimal WEB device sizes and potentially reduce sizing related procedural difficulties.Keywords: Aneurysm; Device; Ratio; Volume; WEB (woven endobridge)Disclosures S. Kim: None. J. Lee: None. J. Lee: None. J. Paik: None. H. Jeong: None. Y. Jeong: None.