Lessons learned from 12 years using the Woven Endobridge for the treatment of cerebral aneurysms in a multi-center series.

Autor: Goertz L; Department of Radiology and Neuroradiology, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Strasse 62, Cologne, 50937, Germany. lukas.goertz@uk-koeln.de., Liebig T; Institute of Neuroradiology, University Hospital Munich (LMU), Marchioninistrasse 15, Munich, 81377, Germany., Siebert E; Department of Neuroradiology, University Hospital of Berlin (Charité), Charitéplatz 1, Berlin, 10118, Germany., Zopfs D; Department of Radiology and Neuroradiology, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Strasse 62, Cologne, 50937, Germany., Pennig L; Department of Radiology and Neuroradiology, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Strasse 62, Cologne, 50937, Germany., Pflaeging M; Institute of Neuroradiology, University Hospital Munich (LMU), Marchioninistrasse 15, Munich, 81377, Germany., Schlamann M; Department of Radiology and Neuroradiology, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Strasse 62, Cologne, 50937, Germany., Radomi A; Institute of Neuroradiology, University Hospital Munich (LMU), Marchioninistrasse 15, Munich, 81377, Germany., Dorn F; Department of Neuroradiology, University Hospital of Bonn, Venusberg-Campus 1, Bonn, 53127, Germany., Kabbasch C; Department of Radiology and Neuroradiology, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Strasse 62, Cologne, 50937, Germany.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Oct 16; Vol. 14 (1), pp. 24212. Date of Electronic Publication: 2024 Oct 16.
DOI: 10.1038/s41598-024-75064-2
Abstrakt: Intrasaccular flow disruption with the Woven Endobridge (WEB) has become a well-established endovascular technique for the treatment of intracranial aneurysms. This study presents our 12-year experience with the WEB and evaluates its evolving indications, procedures, and outcomes. A consecutive series of 324 aneurysms treated with WEB between 2011 and 2023 at three neurovascular centers was retrospectively analyzed and the study group was divided into four treatment periods. Uni- and multivariate analyses were performed to evaluate factors associated with technical success, thromboembolic complications, and angiographic outcome. The mean aneurysm size was 7.0 ± 3.6 mm and decreased during the study period, while the proportion of atypical sites for WEB implantation increased. WEB implantation was technically successful in 96.0%, and the ratio of WEB width to dome width increased during the study period, indicating oversizing. The neurological complication rate was 4.9% (1.5% major, 3.4% minor) and the mid-term complete occlusion rate was 60.6% (81.9% adequate occlusion), with no statistical differences in either outcome measure between the study periods. In multivariate analyses, the use of WEB 17 was associated with increased technical success (HR: 7.4, 95%CI: 2.4-23.6, p<0.01), whereas ruptured aneurysm status (HR: 2.5, 95%CI: 1.0-6.0, p=0.04) and the use of additional stents (HR: 4.8, 95%CI: 1.6-14.4, p<0.01) predicted thromboembolic complications. Appropriate oversizing of the WEB favored mid-term complete occlusion (HR: 10.5, 95%CI: 1.3-83.3, p=0.03). The results suggest an expansion of the indications for WEB implantation and highlight the importance of oversizing for treatment efficacy.
(© 2024. The Author(s).)
Databáze: MEDLINE
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