Prediction of persistent incomplete occlusion of intracranial aneurysms treated with woven EndoBridge device.

Details

Serval ID
serval:BIB_09030D824E84
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prediction of persistent incomplete occlusion of intracranial aneurysms treated with woven EndoBridge device.
Journal
Neurosurgical review
Author(s)
Essibayi M.A., Jabal M.S., Jamil H., Salim H.A., Musmar B., Adeeb N., Dibas M., Cancelliere N.M., Bengzon J.D., Algin O., Ghozy S., Lay S.V., Guenego A., Renieri L., Carnevale J., Saliou G., Mastorakos P., Naamani K.E., Shotar E., Möhlenbruch M., Kral M., Chung C., Salem M.M., Lylyk I., Foreman P.M., Shaikh H., Župančić V., Hafeez M.U., Catapano J., Waqas M., Besler M.S., Gunes Y.C., Rabinov J.D., Maingard J., Schirmer C.M., Piano M., Kühn A.L., Michelozzi C., Starke R.M., Hassan A., Ogilvie M., Nguyen A., Jones J., Brinjikji W., Nawka M.T., Psychogios M., Ulfert C., Pukenas B., Burkhardt J.K., Huynh T., Martinez-Gutierrez J.C., Sheth S.A., Slawski D., Tawk R., Pulli B., Lubicz B., Panni P., Puri A.S., Pero G., Raz E., Griessenauer C.J., Asadi H., Siddiqui A., Levy E.I., Khatri D., Haranhalli N., Ducruet A.F., Albuquerque F.C., Regenhardt R.W., Stapleton C.J., Kan P., Kalousek V., Lylyk P., Boddu S., Knopman J., Tjoumakaris S.I., Cuellar-Saenz H.H., Jabbour P.M., Clarençon F., Limbucci N., Pereira V.M., Patel A.B., Altschul D.J., Dmytriw A.A.
Working group(s)
WorldWideWEB Consortium Collaborators
Contributor(s)
Balushi A.A., Brehm A., McLellan R.M., Premat K., Vranic J.E., Vachhani J.A., Tutino V.M., Ibrahim M.K., Mohammed M.A., Elens S., Spears J., Sporns P., Nossek E., Killer-Oberfalzer M., Aziz-Sultan M.A., Doron O., Sundararajan S.H., Inoue Y., Mirshahi S., Ayberk G., Ozates M.O., Aslan A., Swaid C., Cuellar M., Puccinelli F., Bartolini B., Hajdu S.
ISSN
1437-2320 (Electronic)
ISSN-L
0344-5607
Publication state
Published
Issued date
22/03/2025
Peer-reviewed
Oui
Volume
48
Number
1
Pages
314
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: epublish
Abstract
While the Woven EndoBridge (WEB) device has transformed the treatment of wide-neck intracranial aneurysms, incomplete occlusion remains a significant challenge requiring better understanding of contributing factors. A retrospective analysis was conducted on multicenter data from patients who underwent WEB device treatment for intracranial aneurysms between January 2011 and December 2022. Using machine learning models, Cox regression, and time-stratified analyses, we evaluated factors associated with persistent incomplete occlusion, defined as non-improving Raymond-Roy Occlusion Classification grade 2 or 3 at final follow-up. Among 813 patients (607 with < 24 months follow-up, 206 with ≥ 24 months), machine learning analysis identified aneurysm height, Acom location, neck diameter, and pretreatment mRS as predictors of persistent incomplete occlusion. On Cox regression. larger aneurysm neck diameter (HR 1.13, 95% CI 1.01-1.27, p = 0.027) and height (HR 1.14, 95% CI 1.02-1.26, p = 0.017), and radial access (HR 2.68, 95% CI 1.76-4.07, p < 0.001) increased, while posterior circulation location (HR 0.56, 95% CI 0.37-0.84, p = 0.005) decreased the risk of persistent incomplete occlusion. Time-stratified analysis revealed that in short-term follow-up (< 24 months), larger aneurysm neck diameter (OR 1.28, 95% CI 1.08-1.52, p = 0.004) increased the risk of incomplete occlusion. In long-term follow-up (≥ 24 months), smoking (OR 2.69, 95% CI 1.04-7.00, p = 0.04), higher pre-treatment mRS (OR 1.78, 95% CI 1.15-2.76, p = 0.009), and immediate flow stagnation (OR 0.33, 95% CI 0.11-0.96, p = 0.04) increased, while older age (OR 0.94, 95% CI 0.90-0.98, p = 0.002) and WEB-DL (OR 0.06, p < 0.001) and SLS devices (OR 0.02, p = 0.003) decreased the risk of persistent incomplete occlusion. Aneurysm characteristics and device type significantly influence long-term WEB treatment outcomes.
Keywords
Humans, Intracranial Aneurysm/therapy, Male, Female, Middle Aged, Retrospective Studies, Aged, Adult, Endovascular Procedures/methods, Endovascular Procedures/instrumentation, Treatment Outcome, Embolization, Therapeutic/methods, Embolization, Therapeutic/instrumentation, Aneurysms, Brain, Follow-up, Incomplete occlusion, Woven EndoBridge
Pubmed
Open Access
Yes
Create date
28/03/2025 15:10
Last modification date
29/03/2025 8:10
Usage data