Citations 2
Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study
Vaishnav, Dhrumil , Adeeb, Nimer , Aslan, Assala , Cancelliere, Nicole M., McLellan, Rachel , Ghozy, Sherief, Lay, Sovann V. , Guenego, Adrien , Premat, Kévin , Möhlenbruch, Markus, Kral, Michael , Doron, Omer , Salem, Mohamed M. , Foreman, Paul M. , Vachhani, Jay A. , Shaikh, Hamza, Župančić, Vedran , Ayberk, Gıyas , Güneş, Yasin Celal , Rabinov, James D. , Ren, Yifan , Michelozzi, Caterina , Elens, Stéphanie , Starke, Robert M., Hassan, A. , 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, Sheth, Sunil G. , Spiegel, Gary, Lubicz, Boris , Puri, Ajit S., Pero, Guglielmo , Nossek, Erez , Raz, Eytan, Griessenauer, Christoph J., Asadi, Hamed , Siddiqui, Adnan, Brook, Allan , Haranhalli, Neil , Ducruet, Andrew F. , Albuquerque, Felipe C. , Regenhardt, Robert W. , Stapleton, Christopher J. , Kan, Peter, Kalousek, Vladimir , Lylyk, Pedro , Boddu, Srikanth , Knopman, Jared , Tjoumakaris, Stavropoula I., Clarençon, Frédéric, Cuellar-Saenz, Hugo H., Patel, Aman B. , Altschul, David , _, _, Spears, Julian , Sundararajan, Sri Hari , Balush, Ali Al, Inoue, Yasuaki , Mirshahi, Shervin , Harker, Pablo, Tutino, Vincent M., Brehm, Alex , Diestro, Jose Danilo B , Shotar, Eimad , Nguyen, Anh , Pero, Guglielmo , Kalousek, Vladimir , Altschul, David J , Regenhardt, Robert W , Ulfert, Christian , Lay, Sovann V , Essibayi, Muhammed Amir , 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 , 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 , Huynh, Thien , Martinez-Gutierrez, Juan Carlos , Sheth, Sunil A., Tawk, Rabih G. , Panni, Pietro , Puri, Ajit S , Raz, Eytan , Killer-Oberpfalzer, Monika , Griessenauer, Christoph J. , Aziz‐Sultan, Mohammad Ali , Tjoumakaris, Stavropoula , Clarençon, Frédéric , Limbucci, Nicola , Cuellar, Hugo , Jabbour, Pascal , Mendes Pereira, Vitor , Dmytriw, Adam A. , _, _, Dibas, Mahmoud , Vranic, Justin E. , Alotaibi, Naif M. , Harker, Pablo , Sporns, Peter Bernhard
Journal of Neurosurgery | January 31, 2025 | Volume: 142 | Issue: 6 | Pages: 1732-1740
OBJECTIVE Tobacco smoking is among the factors known to significantly augment the risk of untreated intracranial aneurysm (IA) growth and rupture. Smoking appears to have a variable effect on different endovascular treatment modalities. The impact of smoking on the safety, efficacy, and outcomes of Woven EndoBridge (WEB) device use for wide-neck IAs has not been evaluated. This study aimed to investigate the outcomes of WEB devices by smoking status. METHODS A retrospective multicenter analysis was conducted on the data of patients from 36 sites worldwide treated with the WEB device for intracranial saccular aneurysms. Patients were stratified based on smoking status (current, former, and never smokers). The Student t-test and chi-square test were performed for continuous and categorical variables, respectively. Multivariable logistic regression was used to adjust for confounders. RESULTS Of 1376 patients with available smoking status, 504 were current smokers, 358 were former smokers, and 514 were never smokers. Upon adjusting for significant confounders, no association was found between smoking and recurrence outcomes (OR 1.39, 95% CI 0.69–2.80; p = 0.36), thromboembolic and hemorrhagic complications, and mortality among IAs treated with the WEB device. There was no statistically significant difference in outcomes between former and never smokers (OR 1.23, 95% CI 0.70–2.18; p = 0.46). The location of aneurysms differed between smoking groups, with former smokers having more anterior circulation aneurysms compared with current and never smokers (99.0% vs 96.9% vs 95.3%; p = 0.01). In terms of clinical symptoms, headache and dizziness were more common in the never smokers compared with current and former smokers (13.9% vs 8.9% vs 7.7%, p = 0.01). CONCLUSIONS This large-scale study suggests no significant correlation between smoking and the recurrence of IAs treated with the WEB device. Biological studies are warranted to better understand the biological impact of smoking on the growth and rupture of treated IAs.
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.