Citations 22
Intrasaccular flow disruption for ruptured aneurysms: an international multicenter study
Diestro, Jose Danilo Bengzon , Dibas, Mahmoud , Adeeb, Nimer , Regenhardt, Robert W. , Vranic, Justin E. , Guenego, Adrien , Lay, Sovann V. , Balushi, Ali Al , Shotar, Eimad , Premat, Kévin , Möhlenbruch, Markus , Foreman, Paul M. , Vachhani, Jay A. , Župančić, Vedran , Hafeez, Muhammad Ubaid , Rai, Hamid, Tutino, Vincent M. , Mirshani, Shervin, Ghozy, Sherief , Alotaibi, Naif M. , Rabinov, James D. , Ren, Yifan , Goren, Oded , Piano, Mariangela , Michelozzi, Caterina , Elens, Stéphanie , Starke, Robert M. , Nguyên, Anh , Jones, Jesse , Psychogios, Marios, Spears, Julian , Bullrich, María Bres , Mayich, Michael , Salem, Mohamed M. , Burkhardt, Jan‐Karl , Jankowitz, Brian T. , Ulfert, Christian , Lubicz, Boris , Puri, Ajit S , Pero, Guglielmo , Asadi, Hamed , Siddiqui, Adnan H. , Ducruet, Andrew F. , Albuquerque, Felipe C , Kan, Peter , Kalousek, Vladimir , Lylyk, Pedro , Boddu, Srikanth , Stapleton, Christopher J. , Knopman, Jared , Jabbour, Pascal , Tjoumakaris, Stavropoula , Clarençon, Frédéric , Aziz‐Sultan, Mohammad Ali , Patel, Aman B. , Dmytriw, Adam A. , Shotar, Eimad , Saliou, Guillaume , Lylyk, Ivan , Vachhani, Jay A , Rai, Hamid , Tutino, Vincent M , Harker, Pablo , Ren, Yifan , Schirmer, Clemens M , Michelozzi, Caterina , Elens, Stephanie , Hassan, Ameer E , Nguyen, Anh , Jones, Jesse , Parra-Fariñas, Carmen , Salem, Mohamed M , Domingo, Ricardo A , Tawk, Rabih, Pero, Guglielmo , Albuquerque, Felipe C , Kan, Peter , Kalousek, Vladimir , Jabbour, Pascal , Tjoumakaris, Stavropoula , Clarençon, Frédéric , Cuellar-Saenz, Hugo H , Dmytriw, Adam A , Siddiqui, Adnan H , Dibas, Mahmoud , Ghozy, Sherief , Diestro, Jose Danilo B , Regenhardt, Robert W , Hafeez, Muhammad U , Ulfert, Christian , Lay, Sovann V , Burkhardt, Jan‐Karl , Renieri, Leonardo , Naamani, Kareem El , Saliou, Guillaume , Lylyk, Iván , Rutledge, Caleb , Harker, Pablo , Schirmer, Clemens M. , Kühn, Anna Luisa , Hassan, Ameer E , Salehani, Arsalaan , Psychogios, Marios‐Nikos , Domingo, Ricardo A. , Huynh, Thien , Tawk, Rabih G. , Panni, Pietro , Griessenauer, Christoph J. , Du, Rose , Jabbour, Pascal , Limbucci, Nicola , Cuellar, Hugo , Cognard, Christophe
Journal of NeuroInterventional Surgery | July 22, 2022 | Volume: 15 | Issue: 9 | Pages: 844-850
Background The Woven EndoBridge (WEB) device is a novel intrasaccular flow disruptor tailored for bifurcation aneurysms. We aim to describe the degree of aneurysm occlusion at the latest follow-up, and the rate of complications of aneurysms treated with the WEB device stratified according to rupture status. Methods Our data were taken from the WorldWideWeb Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups: ruptured and unruptured. We compared clinical and radiologic outcomes of both groups. Propensity score matching (PSM) was done to match according to age, gender, bifurcation, location, prior treatment, neck, height, dome width, daughter sac, incorporated branch, pretreatment antiplatelets, and last imaging follow-up. Results The study included 676 patients with 691 intracranial aneurysms (529 unruptured and 162 ruptured) treated with the WEB device. The PSM analysis had 55 pairs. In both the unmatched (85.8% vs 84.3%, p=0.692) and matched (94.4% vs 83.3%, p=0.066) cohorts there was no significant difference in the adequate occlusion rate at the last follow-up. Likewise, there were no significant differences in both ischemic and hemorrhagic complications between the two groups. There was no documented aneurysm rebleeding after WEB device implantation. Conclusion There was no significant difference in both the radiologic outcomes and complications between unruptured and ruptured aneurysms. Our findings support the feasibility of treatment of ruptured aneurysms with the WEB device.
Flow Diversion for Middle Cerebral Artery Aneurysms: An International Cohort Study
Diestro, Jose Danilo Bengzon , Adeeb, Nimer , Dibas, Mahmoud , Boisseau, William , Harker, Pablo , Brinjikji, Waleed , Xiang, Sishi, Joyce, Evan, Shapiro, Maksim , Raz, Eytan , Pickett, Gwynedd E. , Alotaibi, Naif M. , Regenhardt, Robert W. , Spears, Julian , Burkhardt, Jan‐Karl , Hafeez, Muhammad Ubaid , Kan, Peter , Nossek, Erez , Zhang, Hongqi , Rinaldo, Lorenzo , Stapleton, Christopher J. , Rabinov, James D. , Patel, Aman B. , Marotta, Thomas R. , Dmytriw, Adam A. , Burkhardt, Jan-Karl , Kan, Peter , Rinaldo, Lorenzo , Lanzino, Giuseppe , Dmytriw, Adam A , Dibas, Mahmoud , Diestro, Jose Danilo B , Harker, Pablo , Regenhardt, Robert W , Hafeez, Muhammad U , Burkhardt, Jan‐Karl , Parra-Fariñas, Carmen , Bernstock, Joshua D. , Griessenauer, Christoph J. , Grandhi, Ramesh , Taussky, Philipp , Hong, Tao , Lanzino, Giuseppe , Roy, Daniel C.
Neurosurgery | September 8, 2021 | Volume: 89 | Issue: 6 | Pages: 1112-1121
Abstract BACKGROUND Open surgery has traditionally been preferred for the management of bifurcation middle cerebral artery (MCA) aneurysms. Flow diverting stents present a novel endovascular strategy for aneurysm treatment. OBJECTIVE To add to the limited literature describing the outcomes and complications in the use of flow diverters for the treatment of these complex aneurysms. METHODS This is a multicenter retrospective review of MCA bifurcation aneurysms undergoing flow diversion. We assessed post-treatment radiological outcomes and both thromboembolic and hemorrhagic complications. RESULTS We reviewed the outcomes of 54 aneurysms treated with flow diversion. Four (7.4%) of the aneurysms had a history of rupture (3 remote and 1 acute). Fourteen (25.9%) of the aneurysms already underwent either open surgery or coiling prior to flow diversion. A total of 36 out of the 45 aneurysms (80%) with available follow-up data had adequate aneurysm occlusion with a median follow-up time of 12 mo. There were no hemorrhagic complications but 16.7% (9/54) had thromboembolic complications. CONCLUSION Flow diverting stents may be a viable option for the endovascular treatment of complex bifurcation MCA aneurysms. However, compared to published series on the open surgical treatment of this subset of aneurysms, flow diversion has inferior outcomes and are associated with a higher rate of complications.