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

被引：2

作者：

Diestro, Jose Danilo Bengzon ^{[1
,38
]}

Dibas, Mahmoud ^{[2
]}

Adeeb, Nimer ^{[3
]}

Regenhardt, Robert W. ^{[4
]}

Vranic, Justin E. ^{[4
]}

Guenego, Adrien ^{[5
]}

Lay, Sovann V. ^{[6
]}

Renieri, Leonardo ^{[7
]}

Al Balushi, Ali ^{[8
]}

Shotar, Eimad ^{[9
]}

Premat, Kevin ^{[9
]}

El Namaani, Kareem ^{[10
]}

Saliou, Guillaume ^{[11
]}

Moehlenbruch, Markus A. ^{[12
]}

Lylyk, Ivan ^{[13
]}

Foreman, Paul M. ^{[14
]}

Vachhani, Jay A. ^{[14
]}

Zupancic, Vedran ^{[15
]}

Hafeez, Muhammad U. ^{[16
]}

Rutledge, Caleb ^{[17
]}

Rai, Hamid ^{[18
]}

Tutino, Vincent M. ^{[18
]}

Mirshahi, Shervin ^{[2
]}

Ghozy, Sherief ^{[19
]}

Harker, Pablo ^{[4
]}

Alotaibi, Naif M. ^{[4
,37
]}

Rabinov, James D. ^{[4
]}

Ren, Yifan ^{[20
]}

Schirmer, Clemens M. ^{[21
]}

Goren, Oded ^{[22
]}

Piano, Mariangela ^{[23
]}

Kuhn, Anna L. ^{[24
]}

Michelozzi, Caterina ^{[25
]}

Elens, Stephanie ^{[5
]}

Starke, Robert M. ^{[26
]}

Hassan, Ameer E. ^{[27
]}

Salehani, Arsalaan ^{[28
]}

Nguyen, Anh ^{[29
]}

Jones, Jesse ^{[28
]}

Psychogios, Marios ^{[29
]}

Spears, Julian ^{[1
]}

Marotta, Thomas ^{[1
]}

Pereira, Vitor ^{[1
]}

Parra-Farinas, Carmen ^{[1
]}

Bres-Bullrich, Maria ^{[30
]}

Mayich, Michael ^{[31
]}

Salem, Mohamed M. ^{[32
]}

Burkhardt, Jan-Karl ^{[32
]}

Jankowitz, Brian T. ^{[32
]}

Domingo, Ricardo A. ^{[33
]}

机构：

[1] Univ Toronto, St Michaels Hosp, Dept Radiol, Div Diagnost & Therapeut Neuroradiol, Toronto, ON, Canada

[2] Harvard Med Sch, Brigham & Womens Hosp, Neuroradiol & Neurointervent Serv, Boston, MA 02115 USA

[3] Louisiana State Univ, Psychol, Shreveport, LA 71105 USA

[4] Harvard Univ, Massachusetts Gen Hosp, Boston, MA 02115 USA

[5] Erasmus Univ Hosp, Dept Intervent Neuroradiol, Brussels, Belgium

[6] Purpan Hosp, Ctr Physiopathol Toulouse Purpan, INSERM, U563, Toulouse, France

[7] Univ Florence, Neurofarba, Florence, Italy

[8] NewYork Presbyterian Hosp, Weill Cornell Med, New York, NY USA

[9] Sorbonne Univ, Pitie Salpetriere Charles Foix Hosp, AP HP, Oncol Dept, F-75013 Paris, France

[10] Thomas Jefferson Univ, Dept Neurosurg, Philadelphia, PA 19107 USA

[11] Vaudois Hosp Ctr Lausanne, Dept Diagnost Radiol & Intervent Radiol, Lausanne, Switzerland

[12] Heidelberg Univ Hosp, Dept Neuroradiol, Heidelberg, Germany

[13] La Sagrada Familia Clin, Endovasc Neurosurg & Intervent Radiol Team, Buenos Aires, Argentina

[14] Orlando Hlth Neurosci & Rehabil Inst, Neurosurg Dept, Orlando, FL USA

[15] Clin Hosp Ctr Sisters Mercy, Dept Radiol, Subdiv Intervent Neuroradiol, Zagreb, Croatia

[16] UTMB & Baylor Sch Med, Dept Neurosurg, Houston, TX USA

[17] Barrow Neurol Inst, Dept Neurosurg, Phoenix, AZ USA

[18] SUNY Buffalo, Dept Neurosurg, Buffalo, NY USA

[19] Mayo Clin, Dept Neuroradiol, Rochester, MN USA

[20] Austin Hlth, Dept Radiol Intervent Radiol & Neurointervent Ser, Melbourne, Australia

[21] Geisinger, Dept Neurosurg, Wilkes Barre, PA USA

[22] Geisinger, Dept Neurosurg, Danville, PA USA

[23] ASST Great Metropolitan Hosp, Neuroradiol, Milan, Italy

[24] UMass Mem Hosp, Dept Neurointervent Radiol, Worcester, MA USA

[25] Osped San Raffaele, Neurovasc Intervent, Milan, Italy

[26] Univ Miami, Dept Neurosurg, Miami, FL USA

[27] Valley Baptist Neurosci Inst, Dept Neurosci, Harlingen, TX USA

[28] Univ Alabama Birmingham, Dept Neurosurg, Birmingham, AL USA

[29] Univ Hosp Basel, Dept Diagnost & Intervent Neuroradiol, Basel, Switzerland

[30] Western Univ, Schulich Sch Med & Dent, Dept Clin Neurol Sci, London, ON, Canada

[31] Western Univ, Schulich Sch Med & Dent, Dept Med Imaging, London, ON, Canada

[32] Univ Penn, Dept Neurosurg, Penn Med, Philadelphia, PA USA

[33] Mayo Clin, Dept Neurol Surg, Jacksonville, FL USA

[34] Osped Niguarda Ca Granda, Neurovasc Intervent, Milan, Italy

[35] Paracelsus Med Univ, Christian Doppler Univ Hosp, Dept Neurosurg, Salzburg, Austria

[36] Paracelsus Med Univ, Inst Neurointervent, Salzburg, Austria

[37] Alfaisal Univ, Natl Neurosci Inst, King Fahad Med City & Coll Med, Dept Neurosurg, Riyadh, Saudi Arabia

[38] St Michaels Hosp, Toronto, ON, Canada

来源：

JOURNAL OF NEUROSURGERY | 2024年 / 140卷 / 04期

关键词：

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

D O I：

10.3171/2023.8.JNS235

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

OBJECTIVE The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for wide -necked bi - furcation 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-as - sisted 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.

引用

页码：1071 / 1079

页数：9

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