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The impact of postoperative aspirin in patients undergoing Woven EndoBridge: a multicenter, institutional, propensity score-matched analysis.
Dmytriw, Adam A; Musmar, Basel; Salim, Hamza; Aslan, Assala; Cancelliere, Nicole M; McLellan, Rachel M; Algin, Oktay; Ghozy, Sherief; Dibas, Mahmoud; Lay, Sovann V; Guenego, Adrien; Renieri, Leonardo; Carnevale, Joseph Anthony; Saliou, Guillaume; Mastorakos, Panagiotis; El Naamani, Kareem; Shotar, Eimad; Premat, Kevin; Möhlenbruch, Markus A; Kral, Michael; Doron, Omer; Chung, Charlotte; Salem, Mohamed M; Lylyk, Ivan; Foreman, Paul M; Vachhani, Jay A; Shaikh, Hamza; Zupancic, Vedran; Hafeez, Muhammad Ubaid; Catapano, Joshua S; Waqas, Muhammad; Tutino, Vincent M; Ibrahim, Mohamed K; Mohammed, Marwa A; Imamoglu, Cetin; Bayrak, Ahmet; Rabinov, James D; Ren, Yifan; Schirmer, Clemens M; Piano, Mariangela; Kuhn, Anna Luisa; Michelozzi, Caterina; Elens, Stephanie; Hasan, Zuha; Starke, Robert M; Hassan, Ameer E; Ogilvie, Mark; Nguyen, Anh; Jones, Jesse; Brinjikji, Waleed.
Afiliação
  • Dmytriw AA; Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA admytriw@mgh.harvard.edu.
  • Musmar B; 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; Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
  • McLellan RM; Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, 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.
  • Dibas M; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, 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 JA; 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.
  • El Naamani K; 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 MA; Department of Neuroradiology, Universitätsklinikum Heidelberg, Heidelberg, Germany.
  • Kral M; Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria.
  • Doron O; Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, 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.
  • Zupancic 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 JS; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
  • Waqas M; Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
  • Tutino VM; Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
  • Ibrahim MK; Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA.
  • Mohammed MA; Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA.
  • Imamoglu C; Department of Neuroradiology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey.
  • Bayrak A; Department of Neuroradiology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey.
  • Rabinov JD; Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Ren Y; Department of Neuroradiology, Austin Health, Victoria, 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.
  • Kuhn AL; Department of Neuroradiology, UMass Memorial Hospital, Worcester, MA, USA.
  • Michelozzi C; Department of Neuroradiology, Ospedale San Raffaele, Milano, Italy.
  • Elens S; Department of Neuroradiology, Ospedale Careggi di Firenze, Florence, Italy.
  • Hasan Z; Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Starke RM; Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
  • Hassan AE; Department of Neurosurgery, University of Miami, Miami, FL, USA.
  • Ogilvie M; Department of Neuroradiology, Valley Baptist Neuroscience Institute, Harlingen, TX, USA.
  • Nguyen A; Deparments of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Jones J; Department of Neuroradiology, University Hospital of Basel, Basel, Switzerland.
  • Brinjikji W; Deparments of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
J Neurointerv Surg ; 2024 Jan 18.
Article em En | MEDLINE | ID: mdl-38238006
ABSTRACT

BACKGROUND:

The Woven EndoBridge (WEB) device is frequently used for the treatment of intracranial aneurysms. Postoperative management, including the use of aspirin, varies among clinicians and institutions, but its impact on the outcomes of the WEB has not been thoroughly investigated.

METHODS:

This was a retrospective, multicenter study involving 30 academic institutions in North America, South America, and Europe. Data from 1492 patients treated with the WEB device were included. Patients were categorized into two groups based on their postoperative use of aspirin (aspirin group n=1124, non-aspirin group n=368). Data points included patient demographics, aneurysm characteristics, procedural details, complications, and angiographic and functional outcomes. Propensity score matching (PSM) was applied to balance variables between the two groups.

RESULTS:

Prior to PSM, the aspirin group exhibited significantly higher rates of modified Rankin scale (mRS) mRS 0-1 and mRS 0-2 (89.8% vs 73.4% and 94.1% vs 79.8%, p<0.001), lower rates of mortality (1.6% vs 8.6%, p<0.001), and higher major compaction rates (13.4% vs 7%, p<0.001). Post-PSM, the aspirin group showed significantly higher rates of retreatment (p=0.026) and major compaction (p=0.037) while maintaining its higher rates of good functional outcomes and lower mortality rates. In the multivariable regression, aspirin was associated with higher rates of mRS 0-1 (OR 2.166; 95% CI 1.16 to 4, p=0.016) and mRS 0-2 (OR 2.817; 95% CI 1.36 to 5.88, p=0.005) and lower rates of mortality (OR 0.228; 95% CI 0.06 to 0.83, p=0.025). However, it was associated with higher rates of retreatment (OR 2.471; 95% CI 1.11 to 5.51, p=0.027).

CONCLUSIONS:

Aspirin use post-WEB treatment may lead to better functional outcomes and lower mortality but with higher retreatment rates. These insights are crucial for postoperative management after WEB procedures, but further studies are necessary for validation.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Clinical_trials Idioma: En Ano de publicação: 2024 Tipo de documento: Article
Texto completo
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Clinical_trials Idioma: En Ano de publicação: 2024 Tipo de documento: Article