Stent-assisted Woven EndoBridge device for the treatment of intracranial aneurysms: an international multicenter study-Reference-Cited by-同舟云学术

Stent-assisted Woven EndoBridge device for the treatment of intracranial aneurysms: an international multicenter study

Published:2023-10-01 Issue: Volume: Page:1-9
ISSN:0022-3085
Container-title:Journal of Neurosurgery
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Author:

Diestro Jose Danilo Bengzon¹,Dibas Mahmoud²,Adeeb Nimer³,Regenhardt Robert W.⁴,Vranic Justin E.⁴,Guenego Adrien⁵,Lay Sovann V.⁶,Renieri Leonardo⁷,Balushi Ali Al⁸,Shotar Eimad⁹,Premat Kévin⁹,Namaani Kareem El¹⁰,Saliou Guillaume¹¹,Möhlenbruch Markus A.¹²,Lylyk Ivan¹³,Foreman Paul M.¹⁴,Vachhani Jay A.¹⁴,Župančić Vedran¹⁵,Hafeez Muhammad U.¹⁶,Rutledge Caleb¹⁷,Rai Hamid¹⁸,Tutino Vincent M.¹⁸,Mirshahi Shervin²,Ghozy Sherief¹⁹,Harker Pablo⁴,Alotaibi Naif M.⁴,Rabinov James D.⁴,Ren Yifan²⁰,Schirmer Clemens M.²¹,Goren Oded²²,Piano Mariangela²³,Kühn Anna L.²⁴,Michelozzi Caterina²⁵,Elens Stéphanie⁵,Starke Robert M.²⁶,Hassan Ameer E.²⁷,Salehani Arsalaan²⁸,Nguyen Anh²⁹,Jones Jesse²⁸,Psychogios Marios²⁹,Spears Julian¹,Marotta Thomas¹,Pereira Vitor¹,Parra-Fariñas Carmen¹,Bres-Bullrich Maria³⁰,Mayich Michael³¹,Salem Mohamed M.³²,Burkhardt Jan-Karl³²,Jankowitz Brian T.³²,Domingo Ricardo A.³³,Huynh Thien³³,Tawk Rabih³³,Ulfert Christian¹²,Lubicz Boris⁵,Panni Pietro²⁵,Puri Ajit S.²⁴,Pero Guglielmo³⁴,Griessenauer Christoph J.³⁵³⁶,Asadi Hamed²⁰,Siddiqui Adnan¹⁸,Ducruet Andrew F.¹⁷,Albuquerque Felipe C.¹⁷,Patel Nirav²,Kan Peter¹⁶,Kalousek Vladimir¹⁵,Lylyk Pedro¹³,Boddu Srikanth⁸,Stapleton Christopher J.⁴,Knopman Jared⁸,Jabbour Pascal¹⁰,Tjoumakaris Stavropoula¹⁰,Clarençon Frédéric⁹,Limbucci Nicola⁷,Aziz-Sultan Mohammad A.²,Cuellar-Saenz Hugo H.³,Cognard Christophe⁶,Patel Aman B.⁴,Dmytriw Adam A.²⁴

Affiliation:

1. Department of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael’s Hospital, University of Toronto, Ontario, Canada;

2. Neuroradiology & Neurointervention Service, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts;

3. Department of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, Louisiana;

4. Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts;

5. Interventional Neuroradiology Department, Erasmus University Hospital, Brussels, Belgium;

6. Diagnostic and Therapeutic Neuroradiology Department, Toulouse Hospital Center, Purpan Hospital, Toulouse, France;

7. Neurovascular Intervention, Careggi Hospital of Florence, Florence, Italy;

8. Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York;

9. Department of Interventional Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, Paris, France;

10. Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania;

11. Department of diagnostic Radiology and Interventional Radiology, Vaudois Hospital Center of Lausanne, Lausanne, Switzerland;

12. Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany;

13. Endovascular Neurosurgery and Interventional Radiology Team, La Sagrada Familia Clinic, Buenos Aires, Argentina;

14. Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida;

15. Department of Radiology, Subdivision of Interventional Neuroradiology, Clinical Hospital Center "Sisters of Mercy", Zagreb, Croatia;

16. Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, Texas;

17. Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona;

18. Department of Neurosurgery, State University of New York at Buffalo, Buffalo, New York;

19. Department of Neuroradiology, Mayo Clinic, Rochester, Minnesota;

20. Department of Radiology, Interventional Radiology and Neurointerventional Services, Austin Health, Melbourne, Australia;

21. Department of Neurosurgery, Geisinger, Wilkes-Barre, Pennsylvania;

22. Department of Neurosurgery, Geisinger, Danville, Pennsylvania;

23. Neuroradiology, ASST Great Metropolitan Hospital, Niguarda, Milan, Italy;

24. Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, Massachusetts;

25. Neurovascular Intervention, San Raffaele Hospital, Milan, Italy;

26. Department of Neurosurgery, University of Miami, Florida;

27. Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, Texas;

28. Department of Neurosurgery, University of Alabama at Birmingham, Alabama;

29. Department of Diagnostic and Interventional Neuroradiology, University Hospital Basel, Switzerland;

30. Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;

31. Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;

32. Department of Neurosurgery, University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;

33. Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida;

34. Neurovascular Intervention, Niguarda Cà Granda Hospital, Milano, Italy;

35. Department of Neurosurgery, Christian Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria; and

36. Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria

Abstract

OBJECTIVE The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for wide-necked bifurcation aneurysms. These aneurysms may require the use of a concomitant stent. The objective of this study was to determine the clinical and radiological outcomes of patients undergoing stent-assisted WEB treatment. In addition, the authors also sought to determine the predictors of a concomitant stent in aneurysms treated with the WEB device. METHODS The data for this study were taken from the WorldWideWEB Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups based on treatment: stent-assisted WEB and WEB device alone. The authors compared clinical and radiological outcomes of both groups. Univariable and multivariable binary logistic regression analyses were performed to determine factors that predispose to stent use. RESULTS The study included 691 intracranial aneurysms (31 with stents and 660 without stents) treated with the WEB device. The adequate occlusion status did not differ between the two groups at the latest follow-up (83.3% vs 85.6%, p = 0.915). Patients who underwent stenting had more thromboembolic (32.3% vs 6.5%, p < 0.001) and procedural (16.1% vs 3.0%, p < 0.001) complications. Aneurysms treated with a concomitant stent had wider necks, greater heights, and lower dome-to-neck ratios. Increasing neck size was the only significant predictor for stent use. CONCLUSIONS This study demonstrates that there is no difference in the degree of aneurysm occlusion between the two groups; however, complications were more frequent in the stent group. In addition, a wider aneurysm neck predisposes to stent assistance in WEB-treated aneurysms.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

Genetics,Animal Science and Zoology

Link

https://thejns.org/downloadpdf/journals/j-neurosurg/aop/article-10.3171-2023.8.JNS235/article-10.3171-2023.8.JNS235.xml

Reference12 articles.

1. The Woven EndoBridge: a new aneurysm occlusion device;Ding YH,2011

2. Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series;Pierot L,2018

3. The safety and effectiveness of the Woven EndoBridge (WEB) system for the treatment of wide-necked bifurcation aneurysms: final 12-month results of the pivotal WEB Intrasaccular Therapy (WEB-IT) Study;Arthur AS,2019

4. International Study of Intracranial Aneurysm Treatment Using Woven EndoBridge: Results of the WorldWideWEB Consortium;Dmytriw AA,2022

5. Intracranial aneurysm treatment with WEB and adjunctive stent: preliminary evaluation in a single-center series;Sahnoun M,2022

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