Citations 13
Stent-assisted Woven EndoBridge device for the treatment of intracranial aneurysms: an international multicenter study
Diestro, Jose Danilo Bengzon , Adeeb, Nimer , Regenhardt, Robert W. , Guenego, Adrien , Lay, Sovann V. , Balushi, Ali Al , Premat, Kévin , Namaani, Kareem El, Möhlenbruch, Markus , Foreman, Paul M. , Vachhani, Jay A. , Župančić, Vedran , Rai, Hamid, Tutino, Vincent M. , Mirshahi, Shervin , Ghozy, Sherief , Rabinov, James D. , Ren, Yifan , Goren, Oded , Michelozzi, Caterina , Elens, Stéphanie , Starke, Robert M. , Nguyên, Anh , Jones, Jesse , Psychogios, Marios, Spears, Julian , Marotta, Thomas R. , Bres-Bullrich, Maria , Mayich, Michael , Salem, Mohamed M. , Burkhardt, Jan‐Karl , Jankowitz, Brian T. , Ulfert, Christian , Lubicz, Boris , Puri, Ajit S , Pero, Guglielmo , Asadi, Hamed , Ducruet, Andrew F. , Albuquerque, Felipe C , Patel, Nirav J. , Kan, Peter , Kalousek, Vladimir , Lylyk, Pedro , Boddu, Srikanth , Stapleton, Christopher J. , Knopman, Jared , Tjoumakaris, Stavropoula , Clarençon, Frédéric , Patel, Aman B. , Tawk, Rabih, Ghozy, Sherief , Diestro, Jose Danilo B , Shotar, Eimad , Tutino, Vincent M , Nguyen, Anh , Pero, Guglielmo , Kalousek, Vladimir , Regenhardt, Robert W , Ulfert, Christian , Lay, Sovann V , Burkhardt, Jan‐Karl , Dibas, Mahmoud , Vranic, Justin E. , Renieri, Leonardo , Shotar, Eimad , Saliou, Guillaume , Lylyk, Iván , Hafeez, Muhammad Ubaid , Rutledge, Caleb , Harker, Pablo , Alotaibi, Naif M. , Schirmer, Clemens M. , Piano, Mariangela , Kühn, Anna Luisa , Hassan, Ameer E , Salehani, Arsalaan , Psychogios, Marios‐Nikos , Mendes Pereira, Vitor , Parra-Fariñas, Carmen , Bullrich, María Bres , Domingo, Ricardo A. , Huynh, Thien , Tawk, Rabih G. , Panni, Pietro , Griessenauer, Christoph J. , Siddiqui, Adnan H. , Jabbour, Pascal , Limbucci, Nicola , Aziz‐Sultan, Mohammad Ali , Cuellar, Hugo , Cognard, Christophe , Dmytriw, Adam A.
Journal of Neurosurgery | October 21, 2023 | Volume: 140 | Issue: 4 | Pages: 1071-1079
OBJECTIVE The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for wide-necked bifurcation aneurysms. These aneurysms may require the use of a concomitant stent. The objective of this study was to determine the clinical and radiological outcomes of patients undergoing stent-assisted WEB treatment. In addition, the authors also sought to determine the predictors of a concomitant stent in aneurysms treated with the WEB device. METHODS The data for this study were taken from the WorldWideWEB Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups based on treatment: stent-assisted WEB and WEB device alone. The authors compared clinical and radiological outcomes of both groups. Univariable and multivariable binary logistic regression analyses were performed to determine factors that predispose to stent use. RESULTS The study included 691 intracranial aneurysms (31 with stents and 660 without stents) treated with the WEB device. The adequate occlusion status did not differ between the two groups at the latest follow-up (83.3% vs 85.6%, p = 0.915). Patients who underwent stenting had more thromboembolic (32.3% vs 6.5%, p < 0.001) and procedural (16.1% vs 3.0%, p < 0.001) complications. Aneurysms treated with a concomitant stent had wider necks, greater heights, and lower dome-to-neck ratios. Increasing neck size was the only significant predictor for stent use. CONCLUSIONS This study demonstrates that there is no difference in the degree of aneurysm occlusion between the two groups; however, complications were more frequent in the stent group. In addition, a wider aneurysm neck predisposes to stent assistance in WEB-treated aneurysms.
Endotheliitis and cytokine storm as a mechanism of clot formation in COVID-19 ischemic stroke patients: A histopathologic study of retrieved clots
Brinjikji, Waleed , Kallmes, David F. , Humphries, William, Zaidat, Osama O. , Jones, Jesse , Siddiqui, Adnan H. , Douglas, Andrew , Rossi, Rosanna , Rentzos, Alexander, Ceder, Erik , Carlqvist, Jeanette , Dunker, Dennis, Doyle, Karen , Jones, Jesse , Rossi, Rosanna , Doyle, Karen M , Siddiqui, Adnan H , Virmani, Renu , De Meyer, Simon F , Yoo, Albert J. , Teleb, Mohamed , Andersson, Tommy , Nogueira, Raul G. , Gil, Sara Molina, Rentzos, Alexander, Jood, Katarina , Tatlisumak, Turgut
Interventional Neuroradiology | September 28, 2023 | Volume: 31 | Issue: 5 | Pages: 660-665
Background Studies during the COVID-19 pandemic have demonstrated an association between COVID-19 virus infection and the development of acute ischemic stroke, particularly large vessel occlusion (LVO). Studying the characteristics and immunohistochemistry of retrieved stroke emboli during mechanical thrombectomy for LVO may offer insights into the pathogenesis of LVO in COVID-19 patients. We examined retrieved COVID-19 emboli from the STRIP, EXCELLENT, and RESTORE registries and compared their characteristics to a control group. Methods We identified COVID-positive LVO patients from the STRIP, RESTORE, and EXCELLENT studies who underwent mechanical thrombectomy. These patients were matched to a control group controlling for stroke etiology based on Trial of Org 10172 in Acute Stroke Treatment criteria. All clots were stained with Martius Scarlet Blue (MSB) along with immunohistochemistry for interleukin-6 (IL-6), C-reactive protein (CRP), von Willebrand factor (vWF), CD66b, fibrinogen, and citrullinated Histone H3. Clot composition was compared between groups. Results Nineteen COVID-19-positive patients and 38 controls were included. COVID-19-positive patients had a significantly higher percentage of CRP and vWF. There was no difference in IL-6, fibrin, CD66b, or citrullinated Histone H3 between groups. Based on MSB staining, there was no statistically significant difference regarding the percentage of red blood cells, white blood cells, fibrin, and platelets. Conclusions Our study found higher concentrations of CRP and vWF in retrieved clots of COVID-19-positive stroke patients compared to COVID-19-negative controls. These findings support the potential role of systemic inflammation as indicated by elevated CRP and endothelial injury as indicated by elevated vWF as precipitating factors in thrombus development in these patients.
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.