Citations 2
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.
Predictive modeling of long-term improvement in occlusion outcomes following Woven EndoBridge treatment of cerebral aneurysms: A machine learning approach
Karandish, Alireza , Essibayi, Muhammed Amir , Jabal, Mohamed Sobhi , Salim, Hamza , Musmar, Basel , Adeeb, Nimer , Dibas, Mahmoud , Li, Yan-Lin , Grist, James T. , Lay, Sovann V. , Guenego, Adrien , Renieri, Leonardo, Naamani, Kareem El, Möhlenbruch, Markus, Kral, Michael , Salem, Mohamed M , Foreman, Paul M. , Shaikh, Hamza , Župančić, Vedran , Ayberk, Gıyas , Rabinov, James D. , Maingard, Julian , Michelozzi, Caterina , Starke, Robert M., Ogilvie, Mark , Nguyên, Anh , Jones, Jesse , Brinjikji, Waleed , Nawka, Marie Teresa , Psychogios, Marios, Ulfert, Christian , Pukenas, Bryan , Burkhardt, Jan‐Karl , Slawski, Diana , Lubicz, Boris , Puri, Ajit S., Pero, Guglielmo , Raz, Eytan , Asadi, Hamed , Siddiqui, Adnan H. , 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 , Clarençon, Frédéric , Patel, Aman B. , Fuschi, Maurizio , Altschul, David , Investigators, for the WorldWideWEB, Salim, Hamza , Li, Yan-Lin , Algin, Oktay , Ghozy, Sherief , Guenego, Adrien , Shotar, Eimad , Lylyk, Ivan , Foreman, Paul M , Župančić, Vedran , Hafeez, Muhammad U , Ayberk, Giyas , Schirmer, Clemens M , Hassan, Ameer E , Nguyen, Anh , Jones, Jesse , Ulfert, Christian , Tawk, Rabih, Raz, Eytan , Griessenauer, Christoph J , Siddiqui, Adnan H , Levy, Elad I , Regenhardt, Robert W , Tjoumakaris, Stavropoula , Cuellar-Saenz, Hugo H , Jabbour, Pascal , Limbucci, Nicola , Altschul, David J , Dmytriw, Adam A , Dibas, Mahmoud , Pero, Guglielmo , Kalousek, Vladimir , Musmar, Basel , Essibayi, Muhammed Amir , Lay, Sovann V , Simonato, Davide , Zaccagna, Fulvio , 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 , Kazancı, Atilla , 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. , Pulli, Benjamin , Panni, Pietro , Puri, Ajit S , Griessenauer, Christoph J. , Levy, Elad I. , Cuellar, Hugo , Jabbour, Pascal , Limbucci, Nicola , Dmytriw, Adam A. , Investigators, for the WorldWideWEB
Interventional Neuroradiology | November 3, 2025 | Volume: No volume available | Issue: No issue available | Pages: No page available
Background The Woven EndoBridge (WEB) device represents an innovative solution for cerebral aneurysm occlusion, particularly for challenging wide-neck bifurcation aneurysms. However, factors affecting sustained occlusion remain poorly understood. We utilized machine learning to attempt to identify predictors of favorable long-term outcomes following WEB treatment. Methods In this multicenter retrospective study, we collected patient demographics, aneurysm characteristics, procedural details, and clinical outcomes. The primary endpoint was improvement in occlusion status, defined as maintained Raymond-Roy Occlusion Classification (RROC) grade 1, or improvement from grade 2 to 1, or from grade 3 to either 2 or 1 on final angiographic follow up. The dataset was split into training (75%) and validation (25%) sets. The CatBoost algorithm was selected based on performance metrics, with Shapley Additive exPlanations (SHAP) values calculated to determine feature importance. Furthermore, a multivariable binomial logistic regression model was performed to validate machine learning findings. Results Among 720 aneurysms from 36 hospitals, 84% showed improvement in occlusion at follow up. Both machine learning and multivariable logistic regression identified aneurysm height as the most consistent correlate of nonimprovement (odds ratio (OR) 0.90 per mm, p = 0.022). In the CatBoost model, the highest-ranking features by SHAP included aneurysm height, patient age, treatment acuity, ACom location, WEB-SLS device, bifurcation anatomy, aneurysm multiplicity, baseline modified Rankin Scale, access route, and partial thrombosis. Conclusions Machine-learning and regression analyses identified consistent predictors of occlusion improvement after WEB treatment, with aneurysm height most strongly linked to nonimprovement. These insights may guide patient selection and follow up. Findings require cautious interpretation and external validation in larger cohorts.