Citations 2
Defining ideal middle cerebral artery bifurcation aneurysm size for Woven EndoBridge embolization
Adeeb, Nimer , Aslan, Assala , Alla, Anika, McLellan, Rachel , Lay, Sovann V. , Guenego, Adrien , Renieri, Leonardo, Premat, Kévin, Möhlenbruch, Markus, Kral, Michael , Doron, Omer , Salem, Mohamed M. , Foreman, Paul M. , Vachhani, Jay A. , Shaikh, Hamza , Župančić, Vedran , Tutino, Vincent M., Mohammed, Marwa A. , Özateş, Mehmet Özgür , Ayberk, Gıyas , 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 , Sheth, Sunil G. , 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 , Cuellar-Saenz, Hugo H., Jabbour, Pascal , Patel, Aman B. , Tutino, Vincent M. , Ibrahim, Mohamed K. , Diestro, Jose Danilo B , Shotar, Eimad , Tutino, Vincent M , Nguyen, Anh , Pero, Guglielmo , Kalousek, Vladimir , Altschul, David J , Regenhardt, Robert W , Ulfert, Christian , Lay, Sovann V , Burkhardt, Jan‐Karl , Musmar, Basel , Salim, Hamza , Cancelliere, Nicole M , Algin, Oktay , Ghozy, Sherief , Dibas, Mahmoud , Renieri, Leonardo , Carnevale, Joseph Anthony , Saliou, Guillaume , Mastorakos, Panagiotis , Naamani, Kareem El , Shotar, Eimad , Premat, Kévin , Möhlenbruch, Markus , 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 , Domingo, Ricardo A. , Huynh, Thien , Martinez-Gutierrez, Juan Carlos , Essibayi, Muhammed Amir , Sheth, Sunil A., Tawk, Rabih G. , Panni, Pietro , Griessenauer, Christoph J. , Siddiqui, Adnan H. , Aziz‐Sultan, Mohammad Ali , Limbucci, Nicola , Cuellar, Hugo , Jabbour, Pascal , Mendes Pereira, Vitor , Dmytriw, Adam A.
Journal of Neurosurgery | October 12, 2024 | Volume: No volume available | Issue: No issue available | Pages: 1-11
OBJECTIVE The Woven EndoBridge (WEB) device was approved to treat wide-necked bifurcation aneurysms. The device is designed as an intrasaccular flow disruptor covering aneurysm widths up to 10 mm. Although prior studies combined all aneurysm sizes, it is known that aneurysms behave differently in response to endovascular treatment based on their size. Therefore, the authors’ objective was to identify ideal middle cerebral artery (MCA) aneurysm width and neck sizes most suitable for WEB treatment. METHODS The WorldWideWEB consortium is a large multicenter retrospective database that analyzes intracranial aneurysms treated with the WEB device. In this study, all unruptured MCA bifurcation aneurysms with available measurements were included. Cutoff values based on aneurysm width and neck in relation to aneurysm occlusion status were measured using the receiver operating characteristic (ROC) curve. Propensity score matching (PSM) was then used to compare treatment outcomes between aneurysms smaller and larger than the cutoff value for both width and neck size. RESULTS The ideal cutoff values for MCA bifurcation aneurysm width and neck were 6.1 mm and 4.6 mm, respectively. On PSM, 87 matched pairs were compared based on width size (≤ 6.1 mm and > 6.1 mm), and 77 matched pairs were compared based on neck size (≤ 4.6 mm and > 4.6 mm). There was a significant difference in adequate aneurysm occlusion between aneurysms smaller and larger than those cutoff values for both widths (93% vs 76%, p = 0.0017) and neck sizes (90% vs 70%, p = 0.0026). The retreatment rate was also significantly higher for larger aneurysms in both parameters. CONCLUSIONS This study shows that MCA bifurcation aneurysms ≤ 6.1 mm in width and ≤ 4.6 mm in neck size are significantly better candidates for WEB treatment, leading to improved occlusion status and reduced retreatment rate, which are important considerations when using WEB devices.
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.