Citations 2
Creation of a predictive calculator to determine adequacy of occlusion of the woven endobridge (WEB) device in intracranial aneurysms—A retrospective analysis of the WorldWide WEB Consortium database
Musmar, Basel , Adeeb, Nimer , Gendreau, Julian , Horowitz, Melanie Alfonzo , Salim, Hamza , Sanmugananthan, Praveen , Aslan, Assala , Cancelliere, Nicole M , McLellan, Rachel , Şenol, Yiğit Can , Lay, Sovann V. , Guenego, Adrien , Renieri, Leonardo, Naamani, Kareem El, Premat, Kévin , Möhlenbruch, Markus, Kral, Michael , Doron, Omer , Salem, Mohamed M , Foreman, Paul M. , Vachhani, Jay A. , Shaikh, Hamza , Župančić, Vedran , Tutino, Vincent M. , Gokhan, Yuce, İmamoğlu, Çetin , Rabinov, James D. , Ren, Yifan , Michelozzi, Caterina , Elens, Stéphanie , Starke, Robert M, Ogilvie, Mark , Nguyên, Anh , Jones, Jesse , Brinjikji, Waleed , Nawka, Marie Teresa , Psychogios, Marios, Ulfert, Christian , Diestro, Jose Danilo Bengzon , Pukenas, Bryan , Burkhardt, Jan‐Karl , Martinez-Gutierrez, Juan Carlos, Essibayi, Muhammed Amir , Spiegel, Gary, Lubicz, Boris , Puri, Ajit S., Pero, Guglielmo , Nossek, Erez , Raz, Eytan , Killer-Oberfalzer, Monika, Asadi, Hamed , Brook, Allan , Altschul, David , Ducruet, Andrew F. , Albuquerque, Felipe C. , Regenhardt, Robert W. , Stapleton, Christopher J. , Kan, Peter, Kalousek, Vladimir , Lylyk, Pedro , Boddu, Srikanth , Knopman, Jared , Tjoumakaris, Stavropoula , Clarençon, Frédéric , Bydon, Mohamad , Patel, Aman B. , Salim, Hamza , Algin, Oktay , Ghozy, Sherief , Dibas, Mahmoud , Senol, Yigit Can , Guenego, Adrien , Tjoumakaris, Stavropoula , Shotar, Eimad , Lylyk, Ivan , Foreman, Paul M , Shaikh, Hamza A , Župančić, Vedran , Hafeez, Muhammad U , Ren, Yifan , Schirmer, Clemens M , Hassan, Ameer E , Nguyen, Anh , Jones, Jesse , Ulfert, Christian , Essibayi, Muhammed Amir , Tawk, Rabih, Pero, Guglielmo , Raz, Eytan , Griessenauer, Christoph J , Siddiqui, Adnan H , Altschul, David J , Regenhardt, Robert W , Limbucci, Nicola , Cuellar-Saenz, Hugo H , Dmytriw, Adam A , Diestro, Jose Danilo B , Tutino, Vincent M , Kalousek, Vladimir , Musmar, Basel , Cancelliere, Nicole M , Lay, Sovann V , Burkhardt, Jan‐Karl , Brown, Nolan J. , Ghozy, Sherief , Dibas, Mahmoud , Orscelik, Atakan , Renieri, Leonardo , Carnevale, Joseph Anthony , Saliou, Guillaume , Mastorakos, Panagiotis , Naamani, Kareem El , Shotar, Eimad , Möhlenbruch, Markus , Chung, Charlotte , Lylyk, Iván , Hafeez, Muhammad Ubaid , Catapano, Joshua S , Waqas, Muhammad , Bayrak, Ahmet , Schirmer, Clemens M. , Piano, Mariangela , Kühn, Anna Luisa , Hassan, Ameer E , Psychogios, Marios‐Nikos , Huynh, Thien , Martinez-Gutierrez, Juan Carlos , Sheth, Sunil A , Tawk, Rabih G. , Panni, Pietro , Puri, Ajit S , Griessenauer, Christoph J. , Siddiqui, Adnan H. , Aziz‐Sultan, Mohammad Ali , Limbucci, Nicola , Hasan, David , Cuellar, Hugo , Jabbour, Pascal , Mendes Pereira, Vitor , Dmytriw, Adam A.
Interventional Neuroradiology | August 10, 2024 | Volume: No volume available | Issue: No issue available | Pages: No page available
Background Endovascular treatment with the woven endobridge (WEB) device has been widely utilized for managing intracranial aneurysms. However, predicting the probability of achieving adequate occlusion (Raymond–Roy classification 1 or 2) remains challenging. Objective Our study sought to develop and validate a predictive calculator for adequate occlusion using the WEB device via data from a large multi-institutional retrospective cohort. Methods We used data from the WorldWide WEB Consortium, encompassing 356 patients from 30 centers across North America, South America, and Europe. Bivariate and multivariate regression analyses were performed on a variety of demographic and clinical factors, from which predictive factors were selected. Calibration and validation were conducted, with variance inflation factor (VIF) parameters checked for collinearity. Results A total of 356 patients were included: 124 (34.8%) were male, 108 (30.3%) were elderly (≥65 years), and 118 (33.1%) were current smokers. Mean maximum aneurysm diameter was 7.09 mm (SD 2.71), with 112 (31.5%) having a daughter sac. In the multivariate regression, increasing aneurysm neck size (OR 0.706 [95% CI: 0.535–0.929], p = 0.13) and partial aneurysm thrombosis (OR 0.135 [95% CI: 0.024–0.681], p = 0.016) were found to be the only statistically significant variables associated with poorer likelihood of achieving occlusion. The predictive calculator shows a c-statistic of 0.744. Hosmer–Lemeshow goodness-of-fit test indicated a satisfactory model fit with a p-value of 0.431. The calculator is available at: https://neurodx.shinyapps.io/WEBDEVICE/ . Conclusion The predictive calculator offers a substantial contribution to the clinical toolkit for estimating the likelihood of adequate intracranial aneurysm occlusion by WEB device embolization.
Association of preprocedural antiplatelet use with decreased thromboembolic complications for intracranial aneurysms undergoing intrasaccular flow disruption
Diestro, Jose Danilo Bengzon , Adeeb, Nimer , Aslan, Assala , McLellan, Rachel , Lay, Sovann V. , Guenego, Adrien , Naamani, Kareem El, Shotar, Eimad, Premat, Kévin , Möhlenbruch, Markus , Kral, Michael , Doron, Omer , Salem, Mohamed M. , Foreman, Paul M. , Vachhani, Jay A. , Shaikh, Hamza , Župančić, Vedran , Mohammed, Marwa A. , İmamoğlu, Çetin , Bayrak, Ahmet , Rabinov, James D. , Ren, Yifan , Michelozzi, Caterina , Elens, Stéphanie , Starke, Robert M. , Ogilvie, Mark , Nguyên, Anh , Jones, Jesse , Brinjikji, Waleed , Nawka, Marie Teresa , Psychogios, Marios, Ulfert, Christian , Pukenas, Bryan , Burkhardt, Jan‐Karl , Essibayi, Muhammed Amir , Spiegel, Gary, Lubicz, Boris , Puri, Ajit S , Pero, Guglielmo , Nossek, Erez , Raz, Eytan , Asadi, Hamed , Siddiqui, Adnan H. , Brook, Allan , Altschul, David , Spears, Julian , Marotta, Thomas R. , Ducruet, Andrew F. , Albuquerque, Felipe C. , Regenhardt, Robert W. , Stapleton, Christopher J. , Kan, Peter , Kalousek, Vladimir , Lylyk, Pedro , Boddu, Srikanth , Knopman, Jared , Tjoumakaris, Stavropoula , Clarençon, Frédéric , Patel, Aman B. , Bayrak, Ahmet , Ibrahim, Mohamed K. , Siddiqui, Adnan H , Diestro, Jose Danilo B , Shotar, Eimad , Nguyen, Anh , Pero, Guglielmo , Kalousek, Vladimir , Altschul, David J , Regenhardt, Robert W , Essibayi, Muhammed Amir , Ulfert, Christian , Lay, Sovann V , Burkhardt, Jan‐Karl , Musmar, Basel , Salim, Hamza , Cancelliere, Nicole M , Algin, Oktay , Ghozy, Sherief , Renieri, Leonardo , Carnevale, Joseph Anthony , Saliou, Guillaume , Mastorakos, Panagiotis , Naamani, Kareem El , Shotar, Eimad , Bernstock, Joshua D. , Chung, Charlotte , Lylyk, Iván , Hafeez, Muhammad Ubaid , Catapano, Joshua S , Waqas, Muhammad , Schirmer, Clemens M. , Piano, Mariangela , Kühn, Anna Luisa , Hassan, Ameer E , Psychogios, Marios‐Nikos , Huynh, Thien , Martinez-Gutierrez, Juan Carlos , Sheth, Sunil A , Tawk, Rabih G. , Panni, Pietro , Killer-Oberpfalzer, Monika , Griessenauer, Christoph J. , Aziz‐Sultan, Mohammad Ali , Jabbour, Pascal , Limbucci, Nicola , Cuellar, Hugo , Mendes Pereira, Vitor , Dmytriw, Adam A.
Journal of Neurosurgery | May 3, 2024 | Volume: 141 | Issue: 4 | Pages: 992-999
OBJECTIVE This study was conducted to investigate the impact of antiplatelet administration in the periprocedural period on the occurrence of thromboembolic complications (TECs) in patients undergoing treatment using the Woven EndoBridge (WEB) device for intracranial wide-necked bifurcation aneurysms. The primary objective was to assess whether the use of antiplatelets in the pre- and postprocedural phases reduces the likelihood of developing TECs, considering various covariates. METHODS A retrospective multicenter observational study was conducted within the WorldWideWEB Consortium and comprised 38 academic centers with endovascular treatment capabilities. Univariable and multivariable logistic regression analyses were performed to determine the association between antiplatelet use and TECs, adjusting for covariates. Missing predictor data were addressed using multiple imputation. RESULTS The study comprised two cohorts: one addressing general thromboembolic events and consisting of 1412 patients, among whom 103 experienced TECs, and another focusing on symptomatic thromboembolic events and comprising 1395 patients, of whom 50 experienced symptomatic TECs. Preprocedural antiplatelet use was associated with a reduced likelihood of overall TECs (OR 0.32, 95% CI 0.19–0.53, p < 0.001) and symptomatic TECs (OR 0.49, 95% CI 0.25–0.95, p = 0.036), whereas postprocedural antiplatelet use showed no significant association with TECs. The study also revealed additional predictors of TECs, including stent use (overall: OR 4.96, 95% CI 2.38–10.3, p < 0.001; symptomatic: OR 3.24, 95% CI 1.26–8.36, p = 0.015), WEB single-layer sphere (SLS) type (overall: OR 0.18, 95% CI 0.04–0.74, p = 0.017), and posterior circulation aneurysm location (symptomatic: OR 18.43, 95% CI 1.48–230, p = 0.024). CONCLUSIONS The findings of this study suggest that the preprocedural administration of antiplatelets is associated with a reduced likelihood of TECs in patients undergoing treatment with the WEB device for wide-necked bifurcation aneurysms. However, postprocedural antiplatelet use did not show a significant impact on TEC occurrence.