Citations 2
Outcomes of arteriovenous malformation patients with multiple versus single feeders: A multicenter retrospective study with propensity-score matching
Musmar, Basel , Adeeb, Nimer , Abdalrazeq, Hammam , Tjoumakaris, Stavropoula I, Salim, Hamza , Kondziolka, Douglas, Sheehan, Jason P. , Ogilvy, Christopher S. , Riina, Howard A. , Naamani, Kareem El, Ironside, Natasha , Ataoglu, Cagdas , Keleş, Abdullah , Muram, Sandeep , Sconzo, Daniel , Rezai, Arwin, Alwakaa, Omar , Erginoğlu, Ufuk , Sen, Rajeev , Griessenauer, Christoph J., Burkhardt, Jan-Karl, Starke, Robert M., Başkaya, Mustafa K. , Levitt, Michael R, Altschul, David , McAvoy, Malia , Aslan, Assala , Abushehab, Abdallah, Swaid, Christian, Abla, Adib A. , Sizdahkhani, Saman , Koduri, Sravanthi , Atallah, Elias , Karadimas, Spyridon, Gooch, M Reid, Rosenwasser, Robert H. , Stapleton, Christopher J. , Koch, Matthew J. , Srinivasan, Visish M. , Cochran, Joseph, Pukenas, Bryan , Smith, Edward, Patel, Aman B. , Cuellar, Hugo H, Lawton, Michael T. , Guthikonda, Bharat , Ogilvy, Christopher S. , Alaraj, Ali , Smith, Edward R. , Salim, Hamza , Essibayi, Muhammed Amir , Alwakaa, Omar , Mosimann, Pascal J , Jabbour, Pascal , Alaraj, Ali , Abla, Adib , Altschul, David J , Musmar, Basel , Ogilvy, Christopher S , Keles, Abdullah , Erginoglu, Ufuk , Smith, Edward , Burkhardt, Jan‐Karl , Roy, Joanna M. , Tjoumakaris, Stavropoula , Kandregula, Sandeep , Dmytriw, Adam A. , Naamani, Kareem El , Abdelsalam, Ahmed , Kumbhare, Deepak , Essibayi, Muhammed Amir , Rezai, Arwin, Tos, Salem M , Pöppe, Johannes , Sen, Rajeev D, Griessenauer, Christoph J. , Sekhar, Laligam N. , Karadimas, Spyridon K. , Gooch, Michael Reid , Chen, Peng R , Blackburn, Spiros , Choudhri, Omar , Orbach, Darren B. , Aziz‐Sultan, Mohammad Ali , Morcos, Jacques J. , Jabbour, Pascal
European Stroke Journal | February 15, 2025 | Volume: 10 | Issue: 3 | Pages: 946-960
Abstract Introduction The impact of multiple feeding arteries on clinical outcomes of cerebral arteriovenous malformations (AVMs) is not well understood. This study aims to compare outcomes between AVMs with multiple versus single feeding arteries. Patients and Methods Data from the Multicenter International Study for Treatment of Brain AVMs (MISTA) consortium were analyzed. Propensity score matching (PSM) was used to balance cohorts. Subgroup analysis was conducted for ruptured and unruptured AVMs and different treatment options, and multivariable logistic regression was applied to assess the impact of feeding artery origin. Results Among 953 patients, 661(69.4%) had multiple feeding arteries, and 292 (30.6%) had a single feeding artery. After PSM, which included 422 matched patients (211 in each group), the differences in obliteration rates (68.7% vs 74.8%, OR 0.73, 95% CI: 0.48–1.12, p = 0.16) and symptomatic complications (15.6% vs 11.8%, OR 1.37, 95% CI: 0.78–2.41, p = 0.25) were not significant. Subgroup analysis comparing ruptured and unruptured AVMs and different treatment options showed no significant differences across all subgroups. Multivariable analysis identified PICA feeders as significantly associated with increased odds of all complications (OR 7.33, 95% CI: 2.14–25.1, p = 0.002). Discussion and Conclusion AVMs with a single feeding artery were more likely to present with rupture, but no significant differences in obliteration rates or complications were observed between the groups after PSM. These findings suggest that while the number of feeding arteries may influence the initial presentation, it does not appear to impact overall treatment success or patient prognosis. Further prospective studies are needed to confirm these findings.
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.