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Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of a Multicenter Retrospective Study.
Mastorakos, Panagiotis; Naamani, Kareem El; Adeeb, Nimer; Lan, Mathews; Castiglione, James; Khanna, Omaditya; Ghosh, Ritam; Bengzon Diestro, Jose Danilo; Dibas, Mahmoud; McLellan, Rachel M; Algin, Oktay; Ghozy, Sherief; Cancelliere, Nicole M; Aslan, Assala; Cuellar-Saenz, Hugo H; Lay, Sovann V; Guenego, Adrien; Renieri, Leonardo; Carnevale, Joseph; Saliou, Guillaume; Shotar, Eimad; Premat, Kevin; Möhlenbruch, Markus; Kral, Michael; Vranic, Justin E; Chung, Charlotte; Salem, Mohamed M; Lylyk, Ivan; Foreman, Paul M; Vachhani, Jay A; Shaikh, Hamza; Zupancic, Vedran; Hafeez, Muhammad U; Catapano, Joshua; Waqas, Muhammad; Tutino, Vincent M; Ibrahim, Mohamed K; Mohammed, Marwa A; Rabinov, James D; Ren, Yifan; Schirmer, Clemens M; Piano, Mariangela; Bullrich, Maria Bres; Mayich, Michael; Kühn, Anna L; Michelozzi, Caterina; Elens, Stéphanie; Starke, Robert M; Hassan, Ameer E; Ogilvie, Mark.
Affiliation
  • Mastorakos P; From the Department of Neurosurgery (P.M., K.E.N., M.L., J. Castiglione, O.K., R.G., M.Z., R.A., A. Amllay, S.I.T., M.R.G., N.A.H., R.H.R., H.Z., R.F.S., P.M.J.), Thomas Jefferson University, Philadelphia, Pennsylvania.
  • Naamani KE; From the Department of Neurosurgery (P.M., K.E.N., M.L., J. Castiglione, O.K., R.G., M.Z., R.A., A. Amllay, S.I.T., M.R.G., N.A.H., R.H.R., H.Z., R.F.S., P.M.J.), Thomas Jefferson University, Philadelphia, Pennsylvania.
  • Adeeb N; Departement of Neurosurgery and Neurointerventional Surgery (N.A., M.D., A. Aslan, H.H.C.-S.), Louisiana State University, Shreveport, Lousiana.
  • Lan M; From the Department of Neurosurgery (P.M., K.E.N., M.L., J. Castiglione, O.K., R.G., M.Z., R.A., A. Amllay, S.I.T., M.R.G., N.A.H., R.H.R., H.Z., R.F.S., P.M.J.), Thomas Jefferson University, Philadelphia, Pennsylvania.
  • Castiglione J; From the Department of Neurosurgery (P.M., K.E.N., M.L., J. Castiglione, O.K., R.G., M.Z., R.A., A. Amllay, S.I.T., M.R.G., N.A.H., R.H.R., H.Z., R.F.S., P.M.J.), Thomas Jefferson University, Philadelphia, Pennsylvania.
  • Khanna O; From the Department of Neurosurgery (P.M., K.E.N., M.L., J. Castiglione, O.K., R.G., M.Z., R.A., A. Amllay, S.I.T., M.R.G., N.A.H., R.H.R., H.Z., R.F.S., P.M.J.), Thomas Jefferson University, Philadelphia, Pennsylvania.
  • Ghosh R; From the Department of Neurosurgery (P.M., K.E.N., M.L., J. Castiglione, O.K., R.G., M.Z., R.A., A. Amllay, S.I.T., M.R.G., N.A.H., R.H.R., H.Z., R.F.S., P.M.J.), Thomas Jefferson University, Philadelphia, Pennsylvania.
  • Bengzon Diestro JD; Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital (J.D.B.D., N.M.C., J.S., V.M.P., A.A.D.), University of Toronto, Toronto, Ontario, Canada.
  • Dibas M; Departement of Neurosurgery and Neurointerventional Surgery (N.A., M.D., A. Aslan, H.H.C.-S.), Louisiana State University, Shreveport, Lousiana.
  • McLellan RM; Neuroendovascular Program (R.M.M., J.E.V., J.D.R., N.J.P., C.J.S., M.A.A.-S., A.B.P., A.A.D.), Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.
  • Algin O; Department of Radiology (O.A., M.O.O., G.A.), City Hospital, Bilkent, Medical Faculty of Yildirim Beyazit University, Ankara, Turkey.
  • Ghozy S; Departments of Radiology and Neurosurgery (S.G.), Mayo Clinic, Rochester, Minnesota.
  • Cancelliere NM; Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital (J.D.B.D., N.M.C., J.S., V.M.P., A.A.D.), University of Toronto, Toronto, Ontario, Canada.
  • Aslan A; Departement of Neurosurgery and Neurointerventional Surgery (N.A., M.D., A. Aslan, H.H.C.-S.), Louisiana State University, Shreveport, Lousiana.
  • Cuellar-Saenz HH; Departement of Neurosurgery and Neurointerventional Surgery (N.A., M.D., A. Aslan, H.H.C.-S.), Louisiana State University, Shreveport, Lousiana.
  • Lay SV; Service de Neuroradiologie Diagnostique et Thérapeutique (S.V.L.), Centre Hospitalier de Toulouse, Hôpital Purpan, Toulouse, France.
  • Guenego A; Service de Neuroradiologie Interventionnelle (A.G., S.E., B.T.J., B.L.), Hôpital Universitaire Erasme, Bruxelles, Belgique.
  • Renieri L; Interventistica Neurovascolare (L.R., N.L.), Ospedale Careggi di Firenze, Florence, Italy.
  • Carnevale J; Neurosurgery and Interventional Neuroradiology, Weill Cornell School of Medicine (J. Carnevale, R.W.R., S.B., J.K.), NY Presbyterian Hospital, New York, New York.
  • Saliou G; Service de Radiodiagnostic et Radiologie Interventionnelle (G. Saliou), Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland.
  • Shotar E; Department de Neuroradiologie (E.S., K.P., F.C.), Hôpital Pitié-Salpêtrière, Université Sorbonne, Paris, France.
  • Premat K; Department de Neuroradiologie (E.S., K.P., F.C.), Hôpital Pitié-Salpêtrière, Université Sorbonne, Paris, France.
  • Möhlenbruch M; Sektion Vaskuläre und Interventionelle Neuroradiologie (M. Möhlenbruch, C.U.), Universitätsklinikum Heidelberg, Heidelberg, Germany.
  • Kral M; Department of Neurology/Institute of Neurointervention (M.K., M.K.-O., C.J.G.), Christian Doppler University Hospital and Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
  • Vranic JE; Neuroendovascular Program (R.M.M., J.E.V., J.D.R., N.J.P., C.J.S., M.A.A.-S., A.B.P., A.A.D.), Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.
  • Chung C; Departments of Radiology and Neurosurgery (C.C., E.N., E.R., H.A.), NYU Langone Health Center, New York, New York.
  • Salem MM; Department of Neurosurgery (M.M.S., B.T. Jankowitz, J.-K.B.), University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
  • Lylyk I; Equipo de Neurocirugía Endovascular y Radiología Intervencionista (I.L., P.L.), Clínica La Sagrada Familia, Buenos Aires, Argentina.
  • Foreman PM; Neurosurgery Department (P.M.F., J.A.V.), Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida.
  • Vachhani JA; Neurosurgery Department (P.M.F., J.A.V.), Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida.
  • Shaikh H; Departments of Radiology and Neurosurgery (H.S.), Cooper University Health Care, Cooper Medical School of Rowan University, Camden, New Jersey.
  • Zupancic V; Subdivision of Interventional Neuroradiology, Department of Radiology (V.Z.), Clinical Hospital Center Sisters of Mercy, Zagreb, Croatia.
  • Hafeez MU; Department of Neurosurgery (M.U.H., P.K., V.K.), UTMB and Baylor School of Medicine, Houston, Texas.
  • Catapano J; Department of Neurosurgery (J. Catapano, A.F.D., F.C.A.), Barrow Neurological Institute, Phoenix, Arizona.
  • Waqas M; Department of Neurosurgery (M.W., V.M.T., A.S.), State University of New York at Buffalo, Buffalo, New York.
  • Tutino VM; Department of Neurosurgery (M.W., V.M.T., A.S.), State University of New York at Buffalo, Buffalo, New York.
  • Ibrahim MK; Departments of Radiology and Neurosurgery (M.K.I., M.A.M., W.B.), Mayo Clinic, Rochester, Minnesota.
  • Mohammed MA; Departments of Radiology and Neurosurgery (M.K.I., M.A.M., W.B.), Mayo Clinic, Rochester, Minnesota.
  • Rabinov JD; Neuroendovascular Program (R.M.M., J.E.V., J.D.R., N.J.P., C.J.S., M.A.A.-S., A.B.P., A.A.D.), Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.
  • Ren Y; Interventional Radiology and Neurointerventional Services, Department of Radiology (Y.R., R.G.T.), Austin Health, Melbourne, Victoria, Australia.
  • Schirmer CM; Department of Neurosurgery and Radiology (C.M.S.), Geisinger Hospital, Danville, Pennsylvania.
  • Piano M; Interventistica Neurovascolare (M. Piano, P.P., G.P.), Ospedale Niguarda Cà Granda, Milano, Italy.
  • Bullrich MB; Neurointerventional Program, Departments of Medical Imaging and Clinical Neurological Sciences (M.B.B., M. Mayich), London Health Sciences Centre, Western University, London, Ontario, Canada.
  • Mayich M; Neurointerventional Program, Departments of Medical Imaging and Clinical Neurological Sciences (M.B.B., M. Mayich), London Health Sciences Centre, Western University, London, Ontario, Canada.
  • Kühn AL; Department of Neurointerventional Radiology (A.L.K., A.S.P.), UMass Memorial Hospital, Worcester, Massachusetts.
  • Michelozzi C; Interventistica Neurovascolare (C.M.), Ospedale San Raffaele Milano, Milano, Italy.
  • Elens S; Service de Neuroradiologie Interventionnelle (A.G., S.E., B.T.J., B.L.), Hôpital Universitaire Erasme, Bruxelles, Belgique.
  • Starke RM; Department of Neurosurgery (R.M.S.), University of Miami, Miami, Florida.
  • Hassan AE; Deparment of Neuroscience (A.E.H.), Valley Baptist Neuroscience Institute, Harlingen, Texas.
  • Ogilvie M; Departments of Neurosurgery and Radiology (M.O., J.J.), University of Alabama at Birmingham, Birmingham, Alabama.
AJNR Am J Neuroradiol ; 45(7): 906-911, 2024 Jul 08.
Article in En | MEDLINE | ID: mdl-38977286
ABSTRACT
BACKGROUND AND

PURPOSE:

Despite the numerous studies evaluating the occlusion rates of aneurysms following WEB embolization, there are limited studies identifying predictors of occlusion. Our purpose was to identify predictors of aneurysm occlusion and the need for retreatment. MATERIALS AND

METHODS:

This is a review of a prospectively maintained database across 30 academic institutions. We included patients with previously untreated cerebral aneurysms embolized using the WEB who had available intraprocedural data and long-term follow-up.

RESULTS:

We studied 763 patients with a mean age of 59.9 (SD, 11.7) years. Complete aneurysm occlusion was observed in 212/726 (29.2%) cases, and contrast stasis was observed in 485/537 (90.3%) of nonoccluded aneurysms. At the final follow-up, complete occlusion was achieved in 497/763 (65.1%) patients, and retreatment was required for 56/763 (7.3%) patients. On multivariable analysis, history of smoking, maximal aneurysm diameter, and the presence of an aneurysm wall branch were negative predictors of complete occlusion (OR, 0.5, 0.8, and 0.4, respectively). Maximal aneurysm diameter, the presence of an aneurysm wall branch, posterior circulation location, and male sex increase the chances of retreatment (OR, 1.2, 3.8, 3.0, and 2.3 respectively). Intraprocedural occlusion resulted in a 3-fold increase in the long-term occlusion rate and a 5-fold decrease in the retreatment rate (P < .001), offering a specificity of 87% and a positive predictive value of 85% for long-term occlusion.

CONCLUSIONS:

Intraprocedural occlusion can be used to predict the chance of long-term aneurysm occlusion and the need for retreatment after embolization with a WEB device. Smoking, aneurysm size, and the presence of an aneurysm wall branch are associated with decreased chances of successful treatment.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Intracranial Aneurysm / Embolization, Therapeutic Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: AJNR Am J Neuroradiol Year: 2024 Document type: Article
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Intracranial Aneurysm / Embolization, Therapeutic Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: AJNR Am J Neuroradiol Year: 2024 Document type: Article