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

Autor:	Diestro JDB; 1Department of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto, Ontario, Canada., Dibas M; 2Neuroradiology & Neurointervention Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Adeeb N; 3Department of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, Louisiana., Regenhardt RW; 4Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts., Vranic JE; 4Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts., Guenego A; 5Interventional Neuroradiology Department, Erasmus University Hospital, Brussels, Belgium., Lay SV; 6Diagnostic and Therapeutic Neuroradiology Department, Toulouse Hospital Center, Purpan Hospital, Toulouse, France., Renieri L; 7Neurovascular Intervention, Careggi Hospital of Florence, Florence, Italy., Balushi AA; 8Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York., Shotar E; 9Department of Interventional Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, Paris, France., Premat K; 9Department of Interventional Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, Paris, France., Namaani KE; 10Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania., Saliou G; 11Department of diagnostic Radiology and Interventional Radiology, Vaudois Hospital Center of Lausanne, Lausanne, Switzerland., Möhlenbruch MA; 12Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany., Lylyk I; 13Endovascular Neurosurgery and Interventional Radiology Team, La Sagrada Familia Clinic, Buenos Aires, Argentina., Foreman PM; 14Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida., Vachhani JA; 14Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida., Župančić V; 15Department of Radiology, Subdivision of Interventional Neuroradiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia., Hafeez MU; 16Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, Texas., Rutledge C; 17Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona., Rai H; 18Department of Neurosurgery, State University of New York at Buffalo, Buffalo, New York., Tutino VM; 18Department of Neurosurgery, State University of New York at Buffalo, Buffalo, New York., Mirshahi S; 2Neuroradiology & Neurointervention Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Ghozy S; 19Department of Neuroradiology, Mayo Clinic, Rochester, Minnesota., Harker P; 4Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts., Alotaibi NM; 4Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts., Rabinov JD; 4Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts., Ren Y; 20Department of Radiology, Interventional Radiology and Neurointerventional Services, Austin Health, Melbourne, Australia., Schirmer CM; 21Department of Neurosurgery, Geisinger, Wilkes-Barre, Pennsylvania., Goren O; 22Department of Neurosurgery, Geisinger, Danville, Pennsylvania., Piano M; 23Neuroradiology, ASST Great Metropolitan Hospital, Niguarda, Milan, Italy., Kühn AL; 24Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, Massachusetts., Michelozzi C; 25Neurovascular Intervention, San Raffaele Hospital, Milan, Italy., Elens S; 5Interventional Neuroradiology Department, Erasmus University Hospital, Brussels, Belgium., Starke RM; 26Department of Neurosurgery, University of Miami, Florida., Hassan AE; 27Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, Texas., Salehani A; 28Department of Neurosurgery, University of Alabama at Birmingham, Alabama., Nguyen A; 29Department of Diagnostic and Interventional Neuroradiology, University Hospital Basel, Switzerland., Jones J; 28Department of Neurosurgery, University of Alabama at Birmingham, Alabama., Psychogios M; 29Department of Diagnostic and Interventional Neuroradiology, University Hospital Basel, Switzerland., Spears J; 1Department of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto, Ontario, Canada., Marotta T; 1Department of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto, Ontario, Canada., Pereira V; 1Department of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto, Ontario, Canada., Parra-Fariñas C; 1Department of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto, Ontario, Canada., Bres-Bullrich M; 30Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Mayich M; 31Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Salem MM; 32Department of Neurosurgery, University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania., Burkhardt JK; 32Department of Neurosurgery, University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania., Jankowitz BT; 32Department of Neurosurgery, University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania., Domingo RA; 33Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida., Huynh T; 33Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida., Tawk R; 33Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida., Ulfert C; 12Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany., Lubicz B; 5Interventional Neuroradiology Department, Erasmus University Hospital, Brussels, Belgium., Panni P; 25Neurovascular Intervention, San Raffaele Hospital, Milan, Italy., Puri AS; 24Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, Massachusetts., Pero G; 34Neurovascular Intervention, Niguarda Cà Granda Hospital, Milano, Italy., Griessenauer CJ; 35Department of Neurosurgery, Christian Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria; and.; 36Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria., Asadi H; 20Department of Radiology, Interventional Radiology and Neurointerventional Services, Austin Health, Melbourne, Australia., Siddiqui A; 18Department of Neurosurgery, State University of New York at Buffalo, Buffalo, New York., Ducruet AF; 17Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona., Albuquerque FC; 17Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona., Patel N; 2Neuroradiology & Neurointervention Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Kan P; 16Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, Texas., Kalousek V; 15Department of Radiology, Subdivision of Interventional Neuroradiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia., Lylyk P; 13Endovascular Neurosurgery and Interventional Radiology Team, La Sagrada Familia Clinic, Buenos Aires, Argentina., Boddu S; 8Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York., Stapleton CJ; 4Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts., Knopman J; 8Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York., Jabbour P; 10Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania., Tjoumakaris S; 10Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania., Clarençon F; 9Department of Interventional Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, Paris, France., Limbucci N; 7Neurovascular Intervention, Careggi Hospital of Florence, Florence, Italy., Aziz-Sultan MA; 2Neuroradiology & Neurointervention Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Cuellar-Saenz HH; 3Department of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, Louisiana., Cognard C; 6Diagnostic and Therapeutic Neuroradiology Department, Toulouse Hospital Center, Purpan Hospital, Toulouse, France., Patel AB; 4Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts., Dmytriw AA; 2Neuroradiology & Neurointervention Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.; 4Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery [J Neurosurg] 2023 Oct 20; Vol. 140 (4), pp. 1071-1079. Date of Electronic Publication: 2023 Oct 20 (Print Publication: 2024).
DOI:	10.3171/2023.8.JNS235
Abstrakt:	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.
Databáze:	MEDLINE
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