Dual Layer vs Single Layer Woven EndoBridge Device in the Treatment of Intracranial Aneurysms: A Propensity Score-Matched Analysis

Adam A Dmytriw^{1

2}, Hamza Salim³, Basel Musmar³, Assala Aslan³, Nicole M Cancelliere⁴, Rachel M McLellan⁵, Oktay Algin⁶, Sherief Ghozy⁷, Mahmoud Dibas³, Sovann V Lay⁸, Adrien Guenego⁹, Leonardo Renieri¹⁰, Joseph Carnevale¹¹, Guillaume Saliou¹², Panagiotis Mastorakos¹³, Kareem El Naamani¹³, Eimad Shotar¹⁴, Kevin Premat¹⁴, Markus Möhlenbruch¹⁵, Michael Kral¹⁶, Omer Doron⁵, Charlotte Chung¹⁷, Mohamed M Salem¹⁸, Ivan Lylyk¹⁹, Paul M Foreman²⁰, Jay A Vachhani²⁰, Hamza Shaikh²¹, Vedran Župančić²², Muhammad U Hafeez²³, Joshua Catapano²⁴, Muhammad Waqas²⁵, Vincent M Tutino²⁵, Mohamed K Ibrahim⁷, Marwa A Mohammed⁷, Cetin Imamoglu²⁶, Ahmet Bayrak²⁶, James D Rabinov⁵, Yifan Ren²⁷, Clemens M Schirmer²⁸, Mariangela Piano²⁹, Anna L Kühn³⁰, Caterina Michelozzi³¹, Stéphanie Elens¹⁰, Robert M Starke³², Ameer E Hassan³³, Mark Ogilvie³⁴, Peter Sporns³⁵, Jesse Jones³⁴, Waleed Brinjikji⁷, Marie T Nawka³⁶, Marios Psychogios³⁵, Christian Ulfert¹⁵, Jose Danilo Bengzon Diestro⁴, Bryan Pukenas¹⁸, Jan-Karl Burkhardt¹⁸, Thien Huynh³⁷, Juan Carlos Martinez-Gutierrez³⁸, Muhammed Amir Essibayi³⁹, Sunil A Sheth³⁸, Gary Spiegel³⁸, Rabih Tawk³⁷, Boris Lubicz¹⁰, Pietro Panni³¹, Ajit S Puri³⁰, Guglielmo Pero²⁹, Erez Nossek¹⁷, Eytan Raz¹⁷, Monika Killer-Oberfalzer¹⁶, Christoph J Griessenauer¹⁶, Hamed Asadi¹⁷, Adnan Siddiqui²⁵, Allan L Brook³⁹, David Altschul³⁹, Andrew F Ducruet²⁴, Felipe C Albuquerque²⁴, Robert W Regenhardt⁵, Christopher J Stapleton⁵, Peter Kan²³, Vladimir Kalousek²², Pedro Lylyk¹⁹, Srikanth Boddu¹², Jared Knopman¹¹, Mohammad A Aziz-Sultan⁶, Stavropoula I Tjoumakaris¹³, Frédéric Clarençon¹⁴, Nicola Limbucci¹¹, Hugo H Cuellar-Saenz³, Pascal M Jabbour¹³, Vitor Mendes Pereira⁵, Aman B Patel⁵, Nimer Adeeb³

Affiliations

¹ Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. admytriw@mgh.harvard.edu.
² Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA. admytriw@mgh.harvard.edu.
³ Departement of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA.
⁴ Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
⁵ Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA.
⁶ Medical Faculty, Department of Radiology, Ankara University, Ankara, Turkey.
⁷ Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA.
⁸ Service de Neuroradiologie Diagnostique Et Thérapeutique, Centre Hospitalier de Toulouse, Hôpital Purpan, Toulouse, France.
⁹ Service de Neuroradiologie Interventionnelle, Hôpital Universitaire Erasme, Brussels, Belgique.
¹⁰ Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy.
¹¹ Neurosurgery & Interventional Neuroradiology, Weill Cornell School of Medicine, New York Presbyterian Hospital, New York, NY, USA.
¹² Service de Radiodiagnostic Et Radiologie Interventionnelle, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland.
¹³ Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
¹⁴ Department de Neuroradiologie, Hôpital Pitié-Salpêtrière. Université Sorbonne, Paris, France.
¹⁵ Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
¹⁶ Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
¹⁷ Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA.
¹⁸ Department of Neurosurgery, University of Pennsylvania Medical Center, Pennsylvania, PA, USA.
¹⁹ Equipo de Neurocirugía Endovascular y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina.
²⁰ Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA.
²¹ Departments of Radiology & Neurosurgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, USA.
²² Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia.
²³ Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA.
²⁴ Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
²⁵ Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
²⁶ Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey.
²⁷ Interventional Radiology and Neurointerventional Services, Department of Radiology, Austin Health, Melbourne, VIC, Australia.
²⁸ Department of Neurosurgery and Radiology, Geisinger Health System, Danville, PA, USA.
²⁹ Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milan, Italy.
³⁰ Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA, USA.
³¹ Interventistica Neurovascolare, Ospedale San Raffaele Milano, Milan, Italy.
³² Deparment of Neurosurgery, University of Miami, Miami, FL, USA.
³³ Deparment of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, USA.
³⁴ Deparments of Neurosurgery and Radiology, University of Alabama, Birmingham, AL, USA.
³⁵ Department of Interventional Neuroradiology, Interventional Neuroradiology, University Hospital of Basel, Basel, Switzerland.
³⁶ Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³⁷ Departments of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
³⁸ Departments of Radiology, Neurology, and Neurosurgery, University of Texas Health Science Center at Houston, Houston, TX, USA.
³⁹ Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

PMID: 38483647
DOI: 10.1007/s10143-024-02341-z

Multicenter Study

Dual Layer vs Single Layer Woven EndoBridge Device in the Treatment of Intracranial Aneurysms: A Propensity Score-Matched Analysis

Adam A Dmytriw et al. Neurosurg Rev. 2024.

. 2024 Mar 14;47(1):116.

doi: 10.1007/s10143-024-02341-z.

Authors

Affiliations

¹ Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. admytriw@mgh.harvard.edu.
² Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA. admytriw@mgh.harvard.edu.
³ Departement of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA.
⁴ Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
⁵ Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA.
⁶ Medical Faculty, Department of Radiology, Ankara University, Ankara, Turkey.
⁷ Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA.
⁸ Service de Neuroradiologie Diagnostique Et Thérapeutique, Centre Hospitalier de Toulouse, Hôpital Purpan, Toulouse, France.
⁹ Service de Neuroradiologie Interventionnelle, Hôpital Universitaire Erasme, Brussels, Belgique.
¹⁰ Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy.
¹¹ Neurosurgery & Interventional Neuroradiology, Weill Cornell School of Medicine, New York Presbyterian Hospital, New York, NY, USA.
¹² Service de Radiodiagnostic Et Radiologie Interventionnelle, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland.
¹³ Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
¹⁴ Department de Neuroradiologie, Hôpital Pitié-Salpêtrière. Université Sorbonne, Paris, France.
¹⁵ Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
¹⁶ Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
¹⁷ Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA.
¹⁸ Department of Neurosurgery, University of Pennsylvania Medical Center, Pennsylvania, PA, USA.
¹⁹ Equipo de Neurocirugía Endovascular y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina.
²⁰ Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA.
²¹ Departments of Radiology & Neurosurgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, USA.
²² Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia.
²³ Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA.
²⁴ Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
²⁵ Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
²⁶ Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey.
²⁷ Interventional Radiology and Neurointerventional Services, Department of Radiology, Austin Health, Melbourne, VIC, Australia.
²⁸ Department of Neurosurgery and Radiology, Geisinger Health System, Danville, PA, USA.
²⁹ Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milan, Italy.
³⁰ Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA, USA.
³¹ Interventistica Neurovascolare, Ospedale San Raffaele Milano, Milan, Italy.
³² Deparment of Neurosurgery, University of Miami, Miami, FL, USA.
³³ Deparment of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, USA.
³⁴ Deparments of Neurosurgery and Radiology, University of Alabama, Birmingham, AL, USA.
³⁵ Department of Interventional Neuroradiology, Interventional Neuroradiology, University Hospital of Basel, Basel, Switzerland.
³⁶ Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³⁷ Departments of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
³⁸ Departments of Radiology, Neurology, and Neurosurgery, University of Texas Health Science Center at Houston, Houston, TX, USA.
³⁹ Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

PMID: 38483647
DOI: 10.1007/s10143-024-02341-z

Abstract

Background: The Woven EndoBridge (WEB) devices have been used for treating wide neck bifurcation aneurysms (WNBAs) with several generational enhancements to improve clinical outcomes. The original device dual-layer (WEB DL) was replaced by a single-layer (WEB SL) device in 2013. This study aimed to compare the effectiveness and safety of these devices in managing intracranial aneurysms.

Methods: A multicenter cohort study was conducted, and data from 1,289 patients with intracranial aneurysms treated with either the WEB SL or WEB DL devices were retrospectively analyzed. Propensity score matching was utilized to balance the baseline characteristics between the two groups. Outcomes assessed included immediate occlusion rate, complete occlusion at last follow-up, retreatment rate, device compaction, and aneurysmal rupture.

Results: Before propensity score matching, patients treated with the WEB SL had a significantly higher rate of complete occlusion at the last follow-up and a lower rate of retreatment. After matching, there was no significant difference in immediate occlusion rate, retreatment rate, or device compaction between the WEB SL and DL groups. However, the SL group maintained a higher rate of complete occlusion at the final follow-up. Regression analysis showed that SL was associated with higher rates of complete occlusion (OR: 0.19; CI: 0.04 to 0.8, p = 0.029) and lower rates of retreatment (OR: 0.12; CI: 0 to 4.12, p = 0.23).

Conclusion: The WEB SL and DL devices demonstrated similar performances in immediate occlusion rates and retreatment requirements for intracranial aneurysms. The SL device showed a higher rate of complete occlusion at the final follow-up.

Keywords: Aneurysms; Intracranial; WEB; Woven EndoBridge, treatment.

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References

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Dual Layer vs Single Layer Woven EndoBridge Device in the Treatment of Intracranial Aneurysms: A Propensity Score-Matched Analysis

Affiliations

Dual Layer vs Single Layer Woven EndoBridge Device in the Treatment of Intracranial Aneurysms: A Propensity Score-Matched Analysis

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical