Off-Label use of Woven EndoBridge device for intracranial brain aneurysm treatment: Modeling of occlusion outcome.

Autor:	Essibayi MA; Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA., Jabal MS; Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA., Musmar B; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA., Adeeb N; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA., Salim H; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA., Aslan A; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA., Cancelliere NM; Department of Neuroradiology, St. Michael's Hospital, Toronto, ON, Canada., McLellan RM; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA., Algin O; Department of Radiology, Medical Faculty of Ankara University, Ankara, Turkey., Ghozy S; Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA., Lay SV; Department of Neuroradiology, Centre Hospitalier de Toulouse, Toulouse, France., Guenego A; Department of Neuroradiology, Hôpital Universitaire Erasme, Bruxelles, Belgium., Renieri L; Department of Neuroradiology, Ospedale Careggi di Firenze, Florence, Italy., Carnevale J; Department of Neurosurgery and Neuroradiology, New York Presbyterian Hospital and Weill Cornell School of Medicine, New York, NY, USA., Saliou G; Department of Neuroradiology, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland., Mastorakos P; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Naamani KE; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Shotar E; Department of Neuroradiology, Hôpital Pitié-Salpêtrière, Paris, France., Premat K; Department of Neuroradiology, Hôpital Pitié-Salpêtrière, Paris, France., Möhlenbruch M; Department of Neuroradiology, Universitätsklinikum Heidelberg, Heidelberg, Germany., Kral M; Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria., Doron O; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA., Chung C; Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA., Salem MM; Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA., Lylyk I; Department of Neuroradiology, Clínica La Sagrada Familia, Buenos Aires, Argentina., Foreman PM; Department of Neurosurgery, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA., Vachhani JA; Department of Neurosurgery, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA., Shaikh H; Departments of Radiology & Neurosurgery, Cooper University Health Care, Camden, NJ, USA., Župančić V; Department of Neuroradiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia., Hafeez MU; Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA., Catapano J; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA., Waqas M; Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA., Yavuz K; Department of Radiology, Medical Faculty of Ankara University, Ankara, Turkey., Gunes YC; Department of Radiology, Medical Faculty of Ankara University, Ankara, Turkey., Rabinov JD; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA., Ren Y; Department of Neuroradiology, Austin Health, Victoria, Australia., Schirmer CM; Department of Neurosurgery and Radiology, Geisinger Hospital, Danville, PA, USA., Piano M; Department of Neuroradiology, Ospedale Niguarda Cà Granda, Milano, Italy., Kühn AL; Department of Neuroradiology, UMass Memorial Hospital, Worcester, MA, USA., Michelozzi C; Department of Neuroradiology, Ospedale San Raffaele, Milano, Italy., Starke RM; Department of Neurosurgery, University of Miami, Miami, FL, USA., Hassan A; Department of Neuroradiology, Valley Baptist Neuroscience Institute, Harlingen, TX, USA., Ogilvie M; Departments of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA., Nguyen A; Department of Neuroradiology, University Hospital of Basel, Basel, Switzerland., Jones J; Departments of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA., Brinjikji W; Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA., Nawka MT; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Psychogios M; Department of Neuroradiology, University Hospital of Basel, Basel, Switzerland., Ulfert C; Department of Neuroradiology, Universitätsklinikum Heidelberg, Heidelberg, Germany., Diestro JDB; Department of Neuroradiology, St. Michael's Hospital, Toronto, ON, Canada., Pukenas B; Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA., Burkhardt JK; Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA., Huynh T; Departments of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA., Gutierrez JCM; Department of Neuroradiology, University of Texas Health Science Center at Houston, Houston, USA., Sheth SA; Department of Neuroradiology, University of Texas Health Science Center at Houston, Houston, USA., Spiegel G; Department of Neuroradiology, University of Texas Health Science Center at Houston, Houston, USA., Tawk R; Departments of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA., Lubicz B; Department of Neuroradiology, Hôpital Universitaire Erasme, Bruxelles, Belgium., Panni P; Department of Neuroradiology, Ospedale San Raffaele, Milano, Italy., Puri AS; Department of Neuroradiology, UMass Memorial Hospital, Worcester, MA, USA., Pero G; Department of Neuroradiology, Ospedale Niguarda Cà Granda, Milano, Italy., Nossek E; Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA., Raz E; Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA., Killer-Oberfalzer M; Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria., Griessenauer CJ; Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria., Asadi H; Department of Neuroradiology, Austin Health, Victoria, Australia., Siddiqui A; Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA., Brook AL; Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA., Haranhalli N; Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA., Ducruet AF; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA., Albuquerque FC; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA., Regenhardt RW; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA., Stapleton CJ; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA., Kan P; Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA., Kalousek V; Department of Neuroradiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia., Lylyk P; Department of Neuroradiology, Clínica La Sagrada Familia, Buenos Aires, Argentina., Boddu S; Department of Neuroradiology, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland., Knopman J; Department of Neurosurgery and Neuroradiology, New York Presbyterian Hospital and Weill Cornell School of Medicine, New York, NY, USA., Aziz-Sultan MA; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA., Tjoumakaris SI; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Clarençon F; Department of Neuroradiology, Hôpital Pitié-Salpêtrière, Paris, France., Limbucci N; Department of Neuroradiology, Ospedale Careggi di Firenze, Florence, Italy., Cuellar-Saenz HH; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA., Jabbour PM; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Pereira VM; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA., Patel AB; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA., Altschul D; Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. Electronic address: daltschu@montefiore.org., Dmytriw AA; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2024 Nov; Vol. 33 (11), pp. 107897. Date of Electronic Publication: 2024 Jul 26.
DOI:	10.1016/j.jstrokecerebrovasdis.2024.107897
Abstrakt:	Introduction: The Woven EndoBridge (WEB) device is emerging as a novel therapy for intracranial aneurysms, but its use for off-label indications requires further study. Using machine learning, we aimed to develop predictive models for complete occlusion after off-label WEB treatment and to identify factors associated with occlusion outcomes. Methods: This multicenter, retrospective study included 162 patients who underwent off-label WEB treatment for intracranial aneurysms. Baseline, morphological, and procedural variables were utilized to develop machine-learning models predicting complete occlusion. Model interpretation was performed to determine significant predictors. Ordinal regression was also performed with occlusion status as an ordinal outcome from better (Raymond Roy Occlusion Classification [RROC] grade 1) to worse (RROC grade 3) status. Odds ratios (OR) with 95 % confidence intervals (CI) were reported. Results: The best performing model achieved an AUROC of 0.8 for predicting complete occlusion. Larger neck diameter and daughter sac were significant independent predictors of incomplete occlusion. On multivariable ordinal regression, higher RROC grades (OR 1.86, 95 % CI 1.25-2.82), larger neck diameter (OR 1.69, 95 % CI 1.09-2.65), and presence of daughter sacs (OR 2.26, 95 % CI 0.99-5.15) were associated with worse aneurysm occlusion after WEB treatment, independent of other factors. Conclusion: This study found that larger neck diameter and daughter sacs were associated with worse occlusion after WEB therapy for aneurysms. The machine learning approach identified anatomical factors related to occlusion outcomes that may help guide patient selection and monitoring with this technology. Further validation is needed. Competing Interests: Declaration of competing interest None. (Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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