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

Jose Danilo Bengzon Diestro

Jose Danilo Bengzon Diestro 德partment of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael’s Hospital, University of Toronto, Ontario, Canada;

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Mahmoud Dibas

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

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Nimer Adeeb

Nimer Adeeb 德partment of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, Louisiana;

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Robert W. Regenhardt

Robert W. Regenhardt Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts;

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Justin E. Vranic

Justin E. Vranic Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts;

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Adrien Guenego

Adrien Guenego Interventional Neuroradiology Department, Erasmus University Hospital, Brussels, Belgium;

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Sovann V. Lay

Sovann V. Lay Diagnostic and Therapeutic Neuroradiology Department, Toulouse Hospital Center, Purpan Hospital, Toulouse, France;

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Leonardo Renieri

Leonardo Renieri Neurovascular Intervention, Careggi Hospital of Florence, Florence, Italy;

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Ali Al Balushi

Ali Al Balushi Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York;

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Eimad Shotar

Eimad Shotar 德partment of Interventional Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, Paris, France;

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Kévin Premat

Kévin Premat 德partment of Interventional Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, Paris, France;

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Kareem El Namaani

Kareem El Namaani 德partment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania;

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Guillaume Saliou

Guillaume Saliou 德partment of diagnostic Radiology and Interventional Radiology, Vaudois Hospital Center of Lausanne, Lausanne, Switzerland;

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Markus A. Möhlenbruch

Markus A. Möhlenbruch 德partment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany;

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Ivan Lylyk

Ivan Lylyk Endovascular Neurosurgery and Interventional Radiology Team, La Sagrada Familia Clinic, Buenos Aires, Argentina;

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Paul M. Foreman

Paul M. Foreman Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida;

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Jay A. Vachhani

Jay A. Vachhani Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida;

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Vedran Župančić

Vedran Župančić 德partment of Radiology, Subdivision of Interventional Neuroradiology, Clinical Hospital Center "Sisters of Mercy", Zagreb, Croatia;

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Muhammad U. Hafeez

Muhammad U. Hafeez 德partment of Neurosurgery, UTMB and Baylor School of Medicine, Houston, Texas;

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Caleb Rutledge

Caleb Rutledge 德partment of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona;

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Hamid Rai

Hamid Rai 德partment of Neurosurgery, State University of New York at Buffalo, Buffalo, New York;

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Vincent M. Tutino

Vincent M. Tutino 德partment of Neurosurgery, State University of New York at Buffalo, Buffalo, New York;

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Shervin Mirshahi

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

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Sherief Ghozy

Sherief Ghozy 德partment of Neuroradiology, Mayo Clinic, Rochester, Minnesota;

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Pablo Harker

Pablo Harker Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts;

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Naif M. Alotaibi

Naif M. Alotaibi Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts;

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James D. Rabinov

James D. Rabinov Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts;

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Yifan Ren

Yifan Ren 德partment of Radiology, Interventional Radiology and Neurointerventional Services, Austin Health, Melbourne, Australia;

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Clemens M. Schirmer

Clemens M. Schirmer 德partment of Neurosurgery, Geisinger, Wilkes-Barre, Pennsylvania;

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Oded Goren

Oded Goren 德partment of Neurosurgery, Geisinger, Danville, Pennsylvania;

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Mariangela Piano

Mariangela Piano Neuroradiology, ASST Great Metropolitan Hospital, Niguarda, Milan, Italy;

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Anna L. Kühn

Anna L. Kühn 德partment of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, Massachusetts;

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Caterina Michelozzi

Caterina Michelozzi Neurovascular Intervention, San Raffaele Hospital, Milan, Italy;

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Stéphanie Elens

Stéphanie Elens Interventional Neuroradiology Department, Erasmus University Hospital, Brussels, Belgium;

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Robert M. Starke

Robert M. Starke 德partment of Neurosurgery, University of Miami, Florida;

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Ameer E. Hassan

Ameer E. Hassan 德partment of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, Texas;

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Arsalaan Salehani

Arsalaan Salehani 德partment of Neurosurgery, University of Alabama at Birmingham, Alabama;

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Anh Nguyen

Anh Nguyen 德partment of Diagnostic and Interventional Neuroradiology, University Hospital Basel, Switzerland;

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Jesse Jones

Jesse Jones 德partment of Neurosurgery, University of Alabama at Birmingham, Alabama;

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Marios Psychogios

Marios Psychogios 德partment of Diagnostic and Interventional Neuroradiology, University Hospital Basel, Switzerland;

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Julian Spears

Julian Spears 德partment of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael’s Hospital, University of Toronto, Ontario, Canada;

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Thomas Marotta

Thomas Marotta 德partment of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael’s Hospital, University of Toronto, Ontario, Canada;

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Vitor Pereira

Vitor Pereira 德partment of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael’s Hospital, University of Toronto, Ontario, Canada;

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Carmen Parra-Fariñas

Carmen Parra-Fariñas 德partment of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael’s Hospital, University of Toronto, Ontario, Canada;

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Maria Bres-Bullrich

Maria Bres-Bullrich 德partment of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;

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Michael Mayich

Michael Mayich 德partment of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;

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Mohamed M. Salem

Mohamed M. Salem 德partment of Neurosurgery, University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;

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Jan-Karl Burkhardt

Jan-Karl Burkhardt 德partment of Neurosurgery, University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;

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Brian T. Jankowitz

Brian T. Jankowitz 德partment of Neurosurgery, University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;

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Ricardo A. Domingo

Ricardo A. Domingo 德partment of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida;

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Thien Huynh

Thien Huynh 德partment of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida;

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Rabih Tawk

Rabih Tawk 德partment of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida;

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Christian Ulfert

Christian Ulfert 德partment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany;

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Boris Lubicz

Boris Lubicz Interventional Neuroradiology Department, Erasmus University Hospital, Brussels, Belgium;

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Pietro Panni

Pietro Panni Neurovascular Intervention, San Raffaele Hospital, Milan, Italy;

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Ajit S. Puri

Ajit S. Puri 德partment of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, Massachusetts;

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Guglielmo Pero

Guglielmo Pero Neurovascular Intervention, Niguarda Cà Granda Hospital, Milano, Italy;

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Christoph J. Griessenauer

Christoph J. Griessenauer 德partment of Neurosurgery, Christian Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria; and
Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria

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Hamed Asadi

Hamed Asadi 德partment of Radiology, Interventional Radiology and Neurointerventional Services, Austin Health, Melbourne, Australia;

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Adnan Siddiqui

Adnan Siddiqui 德partment of Neurosurgery, State University of New York at Buffalo, Buffalo, New York;

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Andrew F. Ducruet

Andrew F. Ducruet 德partment of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona;

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Felipe C. Albuquerque

Felipe C. Albuquerque 德partment of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona;

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Nirav Patel

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

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Peter Kan

Peter Kan 德partment of Neurosurgery, UTMB and Baylor School of Medicine, Houston, Texas;

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Vladimir Kalousek

Vladimir Kalousek 德partment of Radiology, Subdivision of Interventional Neuroradiology, Clinical Hospital Center "Sisters of Mercy", Zagreb, Croatia;

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Pedro Lylyk

Pedro Lylyk Endovascular Neurosurgery and Interventional Radiology Team, La Sagrada Familia Clinic, Buenos Aires, Argentina;

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Srikanth Boddu

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Christopher J. Stapleton

Christopher J. Stapleton Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts;

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Jared Knopman

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

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Pascal Jabbour

Pascal Jabbour 德partment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania;

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Stavropoula Tjoumakaris

Stavropoula Tjoumakaris 德partment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania;

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Frédéric Clarençon

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Nicola Limbucci

Nicola Limbucci Neurovascular Intervention, Careggi Hospital of Florence, Florence, Italy;

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Mohammad A. Aziz-Sultan

Mohammad A. Aziz-Sultan Neuroradiology & Neurointervention Service, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts;

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Hugo H. Cuellar-Saenz

Hugo H. Cuellar-Saenz 德partment of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, Louisiana;

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Christophe Cognard

Christophe Cognard Diagnostic and Therapeutic Neuroradiology Department, Toulouse Hospital Center, Purpan Hospital, Toulouse, France;

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Aman B. Patel

Aman B. Patel Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts;

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, and

Adam A. Dmytriw

Adam A. Dmytriw Neuroradiology & Neurointervention Service, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts;
Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts;

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Publication Date:: 20 Oct 2023

Page Range:: 1–9

Volume/Issue:: 开云体育app苹果版下载

DOI link:: https://doi.org/10.3171/2023.8.JNS235

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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.

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.

ABBREVIATIONS

AUC = area under the curve ; CTA = CT angiography ; DSA = digital subtraction angiography ; MCA = middle cerebral artery ; MRA = MR angiography ; mRS = modified Rankin Scale ; ROC = receiver operating characteristic ; WEB = Woven EndoBridge .

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开云体育app苹果版下载

inJournal of Neurosurgery

Contributor Notes

CorrespondenceJose Danilo Bengzon Diestro: St. Michael’s Hospital, Toronto, ON, Canada.danni.diestro@gmail.com.

INCLUDE WHEN CITINGPublished online October 20, 2023; DOI: 10.3171/2023.8.JNS235.

DisclosuresDr. Diestro reported a travel grant for workshop from MicroVention outside the submitted work. Dr. Regenhardt reported being a Data and Safety Monitoring Board member of Rapid Medical; and research grants from NIH, Heitman Stroke Foundation, and SVIN outside the submitted work. Dr. Saliou reported proctoring for MicroVention during the conduct of the study. Dr. Möhlenbruch reported grants from Balt, MicroVention, Medtronic, and Stryker outside the submitted work. Dr. Vachhani reported personal fees and consultant as proctor for new physician users of the WEB from MicroVention outside the submitted work. Dr. Schirmer reported grants from Penumbra, Medtronic, Stryker, Cerenovus, and NIH/NINDS outside the submitted work. Dr. Goren reported being a proctor for the WEB device from MicroVention outside the submitted work. Dr. Hassan reported being a consultant and speaker for Medtronic, MicroVention, Stryker, Penumbra, Cerenovus, Genentech, GE Healthcare, Scientia, Balt, Viz.ai, Insera Therapeutics, Proximie, NeuroVasc, NovaSignal, Vesalio, Rapid Medical, Imperative Care, and Galaxy Therapeutics during the conduct of the study. Dr. Psychogios reported grants paid to institution from Bangerter-Rhyner Stiftung, Stryker Neurovascular Inc., Phenox GmbH, Penumbra, and Siemens Healthineers AG; speaker fees paid to institution from Stryker Neurovascular Inc., Phenox GmbH, Penumbra, Siemens Healthineers AG, and Acandis GmbH; and consultant for Acandis GmbH outside the submitted work. Dr. Marotta reported being founder/inventor of Evasc/eCLIPs outside the submitted work. Dr. Pereira reported nonfinancial support from MicroVention during the conduct of the study. Dr. Burkhardt reported being a consultant for MicroVention, Stryker, Q’Apel, Cerenovos, and Longeviti Neuro Solutions outside the submitted work. Dr. Tawk reported stock ownership in Medtronic outside the submitted work. Dr. Puri reported being a proctor and consultant for MicroVention during the conduct of the study. Dr. Griessenauer reported personal fees from MicroVention and Stryker, proctoring for Medtronic, and grants from Penumbra outside the submitted work. Dr. Asadi reported being a paid consultant and proctoring for MicroVention. Dr. Siddiqui reported being a consultant for MicroVention outside the submitted work. Dr. Tjoumakaris reported being a consultant for MicroVention. Dr. Clarençon reported being a consultant for MicroVention during the conduct of the study; and being a consultant for Balt, Medtronic, and Stryker; and lectures for Penumbra outside the submitted work. Dr. Limbucci reported being a consultant and proctor for Medtronic; honoraria from Cerenovus, Penumbra, Balt, and Stryker outside the submitted work. Dr. Aziz-Sultan reported being a proctor for the WEB device from MicroVention outside the submitted work. Dr. Cuellar reported being a consultant for MicroVention. Dr. Cognard reported personal fees from MicroVention outside the submitted work. Dr. A. B. Patel reported personal fees from MicroVention, Medtronic, and Penumbra outside the submitted work.

Keywords:: aneurysm; WEB; Woven EndoBridge; outcomes; neurointervention; vascular disorders

Page Count:: 9

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

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开云体育世界杯赔率

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