Citations 2
Temporal relationship between hematoma resolution and functional recovery after middle meningeal artery embolization for chronic subdural hematoma
DeMessie, Bluyé , Essibayi, Muhammed Amir, Karandish, Alireza, Park, Jaewoo , Haranhalli, Neil, Baker, Amanda, Zampolin, R, Brook, A, Lee, S, Adeeb, Nimer, Li, Yan-Lin, Ortega, Diego Alejandro, Cancelliere, N, Diestro, Jose Danilo, Carnevale, Joseph A., Schreiber, Craig , Abecassis, Zachary, Raub, Spencer, Sioutas, Georgios S. , Kvint, Svetlana , Falzon, Andrew, Cantrell, Vance, Holliday, Brian, Maleknia, Pedram D., Cruz-Criollo, Leonardo, Schimmel, Samantha, Musmar, Basel, Alexander, Matthew D. , Zermeno, Jorge Rios, Koul, Prateeka , Aljuboori, Ahmed , Vollherbst, D, Cooper, J , Ogilvy, Christopher S., Al-Mufti, Fawaz, Möhlenbruch, Markus A., Scarcia, Luca, Schirmer, Clemens M., Huynh, Thien, Settecase, Fabio , Tjoumakaris, Stavropoula, Jabbour, Pascal, Vakharia, Kunal, Zanaty, Mario, Ortega-Gutierrez, Santiago, Jones, J, Nasser, Hussein H., Sundararajan, Sri Hari , Mosimann, Pascal J., Nossek, Erez , Raz, Eytan, Kasab, S Al, Spiotta, Alejandro M., Michelozzi, Caterina , Saraceno, Davide , Srinivasan, Visish M., Burkhardt, Jan-Karl, Santini, Pietro Mario, Levitt, Michael R., Lanzino, Giuseppe, Brinjikji, Waleed, Knopman, Jared, Kass-Hout, T, Spears, Julian, Marotta, Thomas, Pereira, Vitor Mendes, Fuschi, Maurizio , Dmytriw, Adam A., Altschul, David J., _, _, Kostynskyy, Alex , Goren, Oded , Oliver, Jeffrey Daniel, Milnerowicz, Małgorzata , Papaxanthos, Jean , Eker, Omer, Barreau, Xavier, Courret, Thomas , Berge, Jerome, Engelhardt, Julien , Diestro, Jose Danilo Bengzon , Li, Yan-Lin , Rios Zermeno, Jorge , Diestro, Jose Danilo B , Li, Yan-Lin , Essibayi, Muhammed Amir , Salim, Hamza , Karandish, Alireza , Khatri, Deepak , Haranhalli, Neil , Zampolin, Richard L. , Adeeb, Nimer , Simonato, Davide , Ortega-Moreno, Diego Alejandro , Cancelliere, Nicole M , Carnevale, Joseph Anthony , Orscelik, Atakan , Abecassis, Zachary A. , Raub, Spencer , Salsano, Giancarlo , Kasem, Rahim Abo , Falzon, Andrew , Abaricia, Jefferson O. , Maleknia, Pedram Daniel , Cruz‐Criollo, Leonardo , Schimmel, Samantha J. , Musmar, Basel , Gajski, Domagoj, Alwakaa, Omar , Ogilvy, Christopher S. , Al‐Mufti, Fawaz , Kalousek, Vladimir , Möhlenbruch, Markus , Scarcia, Luca , Schirmer, Clemens M. , Huynh, Thien , Tawk, Rabih G. , Tjoumakaris, Stavropoula , Jabbour, Pascal , Zanaty, Mario , Ortega-Gutierrez, Santiago , Jones, Jesse , Colasurdo, Marco , Nasser, Hussein, Mosimann, Pascal J , Raz, Eytan , Spiotta, Alejandro M , Castellan, Lucio , Sette, Bruno Del , Panni, Pietro , Srinivasan, Visish M. , Burkhardt, Jan‐Karl , Marnat, Gaultier , Levitt, Michael R. , Lanzino, Giuseppe , Brinjikji, Waleed , Knopman, Jared , Kass‐Hout, Tareq , Spears, Julian , Dmytriw, Adam A. , Altschul, David , Galecio‐Castillo, Milagros , Cespedes, Jorge , Oliver, Jeffrey , Eker, Omer , Barreau, Xavier , Berge, Jérôme , Jecko, Vincent
Journal of Neurosurgery | May 20, 2026 | Volume: No volume available | Issue: No issue available | Pages: 1-12
OBJECTIVE The objective was to evaluate the trajectories of hematoma resolution and functional improvement after middle meningeal artery embolization (MMAE) for chronic subdural hematoma (cSDH), model the temporal pattern of cSDH resolution, and identify factors associated with favorable outcomes. METHODS This real-world multicenter retrospective study included cSDH patients treated with MMAE at 24 centers between 2019 and 2024. Hematoma thickness was measured at baseline and at follow-up intervals (1–4 weeks, 1–3 months, 3–6 months, 6–12 months, and > 12 months after embolization). Resolution patterns were modeled using exponential decay functions. Modified Rankin Scale (mRS) scores assessed functional outcomes. Good functional outcome was defined as mRS score ≤ 2. Resolution patterns were modeled using exponential decay functions to estimate time to 50% and 80% reduction. Patients were categorized as complete resolution (≥ 99%) or by quartile of the remaining distribution (substantial [73%–98%], moderate [53%–73%], partial [27%–53%], minimal [< 27%]). The primary outcome was good functional status (mRS score ≤ 2). RESULTS The authors analyzed a total of 1781 patients with 2295 cSDHs who underwent MMAE. The mean ± SD age was 72.8 ± 12.4 years and 68.1% of patients were male. The initial mean hematoma thickness was 15.31 ± 6.53 mm, decreasing to 5.24 ± 5.91 mm at final follow-up (mean reduction 64.3% ± 42.1%). Resolution followed an exponential decay pattern, with an estimated time to 50% reduction of 1.8 months and to 80% reduction of 8.9 months. Complete resolution occurred in 1031 of 2224 patients (46.4%) with complete follow-up. The median (IQR) mRS score improved from 1 (0–3) at baseline to 0 (0–2) at > 12 months. Good functional outcomes were more common in patients with complete versus minimal resolution (68.9% vs 35.0%, p < 0.001). Achieving ≥ 73% resolution within 90 days was associated with better outcomes (good outcome in 76.9% of those with ≥ 73% resolution vs 67.3% in those without, p < 0.001). Neurological deterioration was the strongest predictor of lack of good outcome (23.7% in patients with neurological deterioration vs 82.4% without, p < 0.001). CONCLUSIONS After MMAE for cSDH, reduction in hematoma thickness follows a predictable exponential decay pattern. Greater extent (≥ 80%) and faster timing (within 90 days) of resolution are valuable prognostic indicators. Functional outcomes improve progressively through 6–12 months after the procedure. The relationship between resolution extent and functional outcomes provides quantitative benchmarks for evaluating treatment response.
Woven EndoBridge Device for Ruptured vs. Unruptured Aneurysms: Insights from the WorldWideWEB Study
Dugar, Franja, Essibayi, Muhammed Amir, Adeeb, N, Algin, Oktay, Ghozy, Sherief, Guenego, Adrien, Renieri, Leonardo, Saliou, G, Shotar, Eimad, Möhlenbruch, Markus, Kral, Michael , Chung, Charlotte, Salem, Mohamed M , Cancelliere, Nicole M., Diestro, Jose Danilo Bengzon, Foreman, Paul M. , Shaikh, Hamza, Župančić, Vedran , Waqas, M, Ayberk, Gıyas , Rabinov, James D. , Maingard, Julian , Schirmer, Clemens M., Piano, M, Michelozzi, Caterina , Starke, Robert M., Hassan, A. E., Ogilvie, Mark, Jones, Jesse, Brinjikji, Waleed , Psychogios, Marios, Nawka, Marie Teresa , Fiehler, Jens, Nguyen-Kim, Thi Dan Linh, Pukenas, Bryan , Burkhardt, J. David, Huynh, Thien, Martinez-Gutierrez, Juan Carlos, Sheth, S, Slawski, Diana , Lubicz, Boris , Puri, A, Raz, E, Griessenauer, Christoph J., Asadi, Hamed, Siddiqui, Adnan, Levy, Elad I, Haranhalli, Neil , Altschul, David, Ducruet, Andrew F. , Regenhardt, Robert W., Stapleton, Christopher J. , Kan, Peter , Lylyk, Pedro, Boddu, Srikanth, Knopman, Jared, Tjoumakaris, Stavropoula I., Cuellar-Saenz, Hugo H., Jabbour, Pascal M., Clarençon, Frédéric, Patankar, Tufail , Pereira, Vitor Mendes, Patel, Aman B., Almohammad, Mohammad, Kemmling, Andre, Dmytriw, Adam A., Diestro, Jose Danilo Bengzon , Diestro, Jose Danilo B , Dugar, Franja , Essibayi, Muhammed Amir , Salim, Hamza , Musmar, Basel , Adeeb, Nimer , Dibas, Mahmoud , Li, Yan-Lin, Algin, Oktay , Ghozy, Sherief , Lay, Sovann V. , Guenego, Adrien , Renieri, Leonardo , Carnevale, Joseph, Saliou, Guillaume , Mastorakos, Panagiotis , Shotar, Eimad , Möhlenbruch, Markus , Salem, Mohamed Raafet Ben, Lylyk, Iván , Cancelliere, Nicole M , Hafeez, Muhammad Ubaid , Catapano, Joshua S , Waqas, Muhammad , Ayberk, Gıyas , Arslan, Muhammet , Ergun, Onur, Maingard, Julian, Schirmer, Clemens M. , Piano, Mariangela , Kühn, Anna L., Starke, Robert M., Hassan, Ameer, Ogilvie, Mark , Jones, Jesse , Zaccagna, Fulvio , Grist, James T. , Psychogios, Marios‐Nikos , Fiehler, Jens , Nguyen‐Kim, Thi Dan Linh , Burkhardt, Jan‐Karl , Huynh, Thien , Martinez-Gutierrez, Juan Carlos , Sheth, Sunil A , Tawk, Rabih G. , Pulli, Benjamin , Panni, Pietro , Puri, Ajit S., Pero, Guglielmo , Raz, Eytan , Griessenauer, Christoph J. , Asadi, Hamed , Siddiqui, Adnan H. , Levy, Elad I. , Altschul, David , Regenhardt, Robert W. , Kan, Peter , Kalousek, Vladimir , Lylyk, Pedro, Knopman, Jared , Tjoumakaris, Stavropoula , Cuellar, Hugo , Jabbour, Pascal , Clarençon, Frédéric , Limbucci, Nicola , Patel, Aman B. , Almohammad, Mohammad , Kemmling, André , Scarcia, Luca , Dmytriw, Adam A. , Sporns, Peter Bernhard
No container title available | March 18, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Purpose Although the Woven EndoBridge (WEB) device is increasingly used for the treatment of wide-neck intracranial aneurysms, including in the acute rupture setting, comparative evidence assessing the impact of rupture status remains limited. This study compared angiographic, safety, and clinical outcomes between ruptured and unruptured intracranial aneurysms treated with WEB. Methods We conducted a retrospective analysis of prospectively collected data from the multicenter cohort registry WorldWideWEB, including consecutive adult patients with intracranial aneurysms treated with the WEB. Patients were stratified into groups of ruptured and unruptured aneurysms. Propensity score matching was used to balance baseline characteristics between both groups. Retreatment rate was the primary outcome. Secondary outcomes included mRS, safety events (thromboembolic complications) and angiographic outcomes (periprocedurally and last follow-up). Results Among 1,220 patients, 342 (28.0%) presented with ruptured aneurysms. There was no significant difference in the rate of thromboembolic complications between groups (11.8% vs 5.9%, p = 0.056). At follow-up, adequate occlusion was lower (82.2% vs 93.3%, p < 0.002) and functional outcomes were worse (mRS ≥2 in 34.1% vs 21.9%, p = 0.012) among patients with ruptured aneurysms. Periprocedural adequate occlusion (53.3% vs 53.8%, p>0.9) and retreatment rates (11.8% vs 7.1%, p = 0.14) did not differ between groups after matching. Conclusion Ruptured aneurysms demonstrated expected inferior follow-up functional and angiographic outcomes when compared with unruptured aneurysms, but no difference in retreatment rate and procedural safety. These findings support WEB as a safe and effective treatment option for appropriately selected ruptured intracranial aneurysms in routine clinical practice.