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  • Author or Editor: Yifan Renx
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Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score–matched study

Mahmoud Dibas, Nimer Adeeb, Jose Danilo Bengzon Diestro, Hugo H. Cuellar, Ahmad Sweid, Sovann V. Lay, Adrien Guenego, Assala Aslan, Leonardo Renieri, Sri Hari Sundararajan, Guillaume Saliou, Markus Möhlenbruch, Robert W. Regenhardt, Justin E. Vranic, Ivan Lylyk, Paul M. Foreman, Jay A. Vachhani, Vedran Župančić, Muhammad U. Hafeez, Caleb Rutledge, Muhammad Waqas, Vincent M. Tutino, James D. Rabinov, Yifan Ren, Clemens M. Schirmer, Mariangela Piano, Anna L. Kühn, Caterina Michelozzi, Stéphanie Elens, Robert M. Starke, Ameer E. Hassan, Arsalaan Salehani, Peter Sporns, Jesse Jones, Marios Psychogios, Julian Spears, Boris Lubicz, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Christoph J. Griessenauer, Hamed Asadi, Christopher J. Stapleton, Adnan Siddiqui, Andrew F. Ducruet, Felipe C. Albuquerque, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Jared Knopman, Mohammad A. Aziz-Sultan, Nicola Limbucci, Pascal Jabbour, Christophe Cognard, Aman B. Patel, and Adam A. Dmytriw

OBJECTIVE

Transradial access (TRA) is commonly utilized in neurointerventional procedures. This study compared the technical and clinical outcomes of the use of TRA versus those of transfemoral access (TFA) for intracranial aneurysm embolization with the Woven EndoBridge (WEB) device.

开云体育世界杯赔率

This is a secondary analysis of the Worldwide WEB Consortium, which comprises multicenter data related to adult patients with intracranial aneurysms who were managed with the WEB device. These aneurysms were categorized into two groups: those who were treated with TRA or TFA. Patient and aneurysm characteristics and technical and clinical outcomes were compared between groups. Propensity score matching (PSM) was used to match groups according to the following baseline characteristics: age, sex, subarachnoid hemorrhage, aneurysm location, bifurcation aneurysm, aneurysm with incorporated branch, neck width, aspect ratio, dome width, and elapsed time since the last follow-up imaging evaluation.

RESULTS

This study included 682 intracranial aneurysms (median [interquartile range] age 61.3 [53.0–68.0] years), of which 561 were treated with TFA and 121 with TRA. PSM resulted in 65 matched pairs. After PSM, both groups had similar characteristics, angiographic and functional outcomes, and rates of retreatment, thromboembolic and hemorrhagic complications, and death. TFA was associated with longer procedure length (median 96.5 minutes vs 72.0 minutes, p = 0.006) and fluoroscopy time (28.2 minutes vs 24.8 minutes, p = 0.037) as compared with TRA. On the other hand, deployment issues were more common in those treated with TRA, but none resulted in permanent complications.

CONCLUSIONS

TRA has comparable outcomes, with shorter procedure and fluoroscopy time, to TFA for aneurysm embolization with the WEB device.

In开云手机版app下载安装最新版N杂志eurosurgery Volume 137: Issue 4 (Oct 2022)

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

Jose Danilo Bengzon Diestro, Mahmoud Dibas, Nimer Adeeb, Robert W. Regenhardt, Justin E. Vranic, Adrien Guenego, Sovann V. Lay, Leonardo Renieri, Ali Al Balushi, Eimad Shotar, Kévin Premat, Kareem El Namaani, Guillaume Saliou, Markus A. Möhlenbruch, Ivan Lylyk, Paul M. Foreman, Jay A. Vachhani, Vedran Župančić, Muhammad U. Hafeez, Caleb Rutledge, Hamid Rai, Vincent M. Tutino, Shervin Mirshahi, Sherief Ghozy, Pablo Harker, Naif M. Alotaibi, James D. Rabinov, Yifan Ren, Clemens M. Schirmer, Oded Goren, Mariangela Piano, Anna L. Kühn, Caterina Michelozzi, Stéphanie Elens, Robert M. Starke, Ameer E. Hassan, Arsalaan Salehani, Anh Nguyen, Jesse Jones, Marios Psychogios, Julian Spears, Thomas Marotta, Vitor Pereira, Carmen Parra-Fariñas, Maria Bres-Bullrich, Michael Mayich, Mohamed M. Salem, Jan-Karl Burkhardt, Brian T. Jankowitz, Ricardo A. Domingo, Thien Huynh, Rabih Tawk, Christian Ulfert, Boris Lubicz, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Christoph J. Griessenauer, Hamed Asadi, Adnan Siddiqui, Andrew F. Ducruet, Felipe C. Albuquerque, Nirav Patel, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Christopher J. Stapleton, Jared Knopman, Pascal Jabbour, Stavropoula Tjoumakaris, Frédéric Clarençon, Nicola Limbucci, Mohammad A. Aziz-Sultan, Hugo H. Cuellar-Saenz, Christophe Cognard, Aman B. Patel, and Adam A. Dmytriw

OBJECTIVE

织EndoBridge (WEB)设备是一个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.

开云体育世界杯赔率

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.

In开云手机版app下载安装最新版N杂志eurosurgery Publish Before Print

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