Treatment of large intracranial aneurysms using the Woven EndoBridge (WEB): a propensity score-matched analysis

Basel Musmar^#^{1

2}, Hamza Adel Salim^#¹, Nimer Adeeb³, Assala Aslan¹, Bahaa Aljeradat¹, Jose Danilo Bengzon Diestro⁴, Rachel M McLellan⁵, Oktay Algin⁶, Sherief Ghozy⁷, Mahmoud Dibas¹, Sovann V Lay⁸, Adrien Guenego⁹, Leonardo Renieri¹⁰, Nicole M Cancelliere⁴, Joseph Carnevale¹¹, Guillaume Saliou¹², Panagiotis Mastorakos², Kareem El Naamani², Eimad Shotar¹³, Kevin Premat¹³, Markus Möhlenbruch¹⁴, Michael Kral¹⁵, Justin E Vranic⁵, Charlotte Chung¹⁶, Mohamed M Salem¹⁷, Ivan Lylyk¹⁸, Paul M Foreman¹⁹, Jay A Vachhani¹⁹, Hamza Shaikh²⁰, Vedran Župančić²¹, Muhammad U Hafeez²², Joshua Catapano²³, Muhammad Waqas²⁴, Vincent M Tutino²⁴, Mohamed K Ibrahim⁷, Marwa A Mohammed⁷, M Ozgur Ozates²⁵, Giyas Ayberk²⁵, James D Rabinov⁵, Yifan Ren²⁶, Clemens M Schirmer²⁷, Mariangela Piano²⁸, Anna L Kühn²⁹, Caterina Michelozzi³⁰, Stéphanie Elens¹⁰, Robert M Starke³¹, Ameer Hassan³², Mark Ogilvie³³, Anh Nguyen³⁴, Jesse Jones³³, Waleed Brinjikji⁷, Marie T Nawka³⁵, Marios Psychogios³⁴, Christian Ulfert¹⁴, Julian Spears⁴, Brian T Jankowitz¹⁷, Jan-Karl Burkhardt¹⁷, Ricardo A Domingo³⁶, Thien Huynh³⁶, Juan Carlos Martinez-Gutierrez³⁷, Muhammed Amir Essibayi³⁸, Sunil A Sheth³⁷, Gary Spiegel³⁷, Rabih Tawk³⁶, Boris Lubicz¹⁰, Pietro Panni³⁰, Ajit S Puri²⁹, Guglielmo Pero²⁸, Erez Nossek¹⁶, Eytan Raz¹⁶, Monika Killer-Oberfalzer¹⁵, Christoph J Griessenauer¹⁵, Hamed Asadi¹⁶, Adnan Siddiqui²⁴, Allan Brook³⁸, David Altschul³⁸, Andrew F Ducruet²³, Felipe C Albuquerque²³, Robert W Regenhardt⁵, Christopher J Stapleton⁵, Peter Kan²², Vladimir Kalousek²¹, Pedro Lylyk¹⁸, Srikanth Boddu¹², Jared Knopman¹², Mohammad A Aziz-Sultan⁶, Stavropoula I Tjoumakaris², Frédéric Clarençon¹³, Nicola Limbucci¹¹, Hugo H Cuellar-Saenz¹, Pascal M Jabbour², Vitor Mendes Pereira⁵, Aman B Patel⁵, Adam A Dmytriw⁵

Affiliations

¹ Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA.
² Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
³ Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA. nimer_adeeb@hotmail.com.
⁴ Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, 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, USA.
⁶ Department of Radiology, Medical Faculty of Ankara University, Ankara, Turkey.
⁷ Department 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, Bruxelles, Belgique.
¹⁰ Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy.
¹¹ Neurosurgery & Interventional Neuroradiology, New York Presbyterian Hospital, Weill Cornell School of Medicine, New York, NY, USA.
¹² Service de Radiodiagnostic Et Radiologie Interventionnelle, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland.
¹³ Department de Neuroradiologie, Hôpital Pitié-Salpêtrière. Université Sorbonne, Paris, France.
¹⁴ Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
¹⁵ Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
¹⁶ Department of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA.
¹⁷ Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA.
¹⁸ Equipo de Neurocirugía Endovascular y Radiología IntervencionistaClínica La Sagrada Familia, Buenos Aires, Argentina.
¹⁹ Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA.
²⁰ Department of Radiology & Neurosurgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, USA.
²¹ Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia.
²² Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA.
²³ Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
²⁴ Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
²⁵ Neurosurgery Department, Ankara Yildirim Beyazit University, Ankara, Turkey.
²⁶ Interventional Radiology and Neurointerventional Services, Department of Radiology, Austin Health, Melbourne, VIC, Australia.
²⁷ Department of Neurosurgery and Radiology, Geisinger Hospital, Danville, PA, USA.
²⁸ Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milano, Italy.
²⁹ Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA, USA.
³⁰ Interventistica Neurovascolare, Ospedale San Raffaele, Milano, Italy.
³¹ Deparment of Neurosurgery, University of Miami, Miami, FL, USA.
³² Deparment of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, USA.
³³ Deparment of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
³⁴ Department of Interventional Neuroradiology, Interventional Neuroradiology, University Hospital of Basel, Basel, Switzerland.
³⁵ Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³⁶ Department of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
³⁷ Department of Radiology, Neurology, and Neurosurgery, University of Texas Health Science Center at Houston, Houston, TX, USA.
³⁸ Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

^# Contributed equally.

PMID: 39083214
PMCID: PMC11291542
DOI: 10.1007/s10143-024-02527-5

Treatment of large intracranial aneurysms using the Woven EndoBridge (WEB): a propensity score-matched analysis

Basel Musmar et al. Neurosurg Rev. 2024.

. 2024 Jul 31;47(1):374.

doi: 10.1007/s10143-024-02527-5.

Authors

Affiliations

¹ Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA.
² Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
³ Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA. nimer_adeeb@hotmail.com.
⁴ Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, 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, USA.
⁶ Department of Radiology, Medical Faculty of Ankara University, Ankara, Turkey.
⁷ Department 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, Bruxelles, Belgique.
¹⁰ Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy.
¹¹ Neurosurgery & Interventional Neuroradiology, New York Presbyterian Hospital, Weill Cornell School of Medicine, New York, NY, USA.
¹² Service de Radiodiagnostic Et Radiologie Interventionnelle, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland.
¹³ Department de Neuroradiologie, Hôpital Pitié-Salpêtrière. Université Sorbonne, Paris, France.
¹⁴ Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
¹⁵ Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
¹⁶ Department of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA.
¹⁷ Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA.
¹⁸ Equipo de Neurocirugía Endovascular y Radiología IntervencionistaClínica La Sagrada Familia, Buenos Aires, Argentina.
¹⁹ Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA.
²⁰ Department of Radiology & Neurosurgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, USA.
²¹ Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia.
²² Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA.
²³ Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
²⁴ Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
²⁵ Neurosurgery Department, Ankara Yildirim Beyazit University, Ankara, Turkey.
²⁶ Interventional Radiology and Neurointerventional Services, Department of Radiology, Austin Health, Melbourne, VIC, Australia.
²⁷ Department of Neurosurgery and Radiology, Geisinger Hospital, Danville, PA, USA.
²⁸ Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milano, Italy.
²⁹ Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA, USA.
³⁰ Interventistica Neurovascolare, Ospedale San Raffaele, Milano, Italy.
³¹ Deparment of Neurosurgery, University of Miami, Miami, FL, USA.
³² Deparment of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, USA.
³³ Deparment of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
³⁴ Department of Interventional Neuroradiology, Interventional Neuroradiology, University Hospital of Basel, Basel, Switzerland.
³⁵ Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³⁶ Department of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
³⁷ Department of Radiology, Neurology, and Neurosurgery, University of Texas Health Science Center at Houston, Houston, TX, USA.
³⁸ Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

^# Contributed equally.

PMID: 39083214
PMCID: PMC11291542
DOI: 10.1007/s10143-024-02527-5

Abstract

The Woven EndoBridge (WEB) device is primarily used for treating wide-neck intracranial bifurcation aneurysms under 10 mm. Limited data exists on its efficacy for large aneurysms. We aim to assess angiographic and clinical outcomes of the WEB device in treating large versus small aneurysms. We conducted a retrospective review of the WorldWide WEB Consortium database, from 2011 to 2022, across 30 academic institutions globally. Propensity score matching (PSM) was employed to compare small and large aneurysms on baseline characteristics. A total of 898 patients were included. There was no significant difference observed in clinical presentations, smoking status, pretreatment mRS, presence of multiple aneurysms, bifurcation location, or prior treatment between the two groups. After PSM, 302 matched pairs showed significantly lower last follow-up adequate occlusion rates (81% vs 90%, p = 0.006) and higher retreatment rates (12% vs 3.6%, p < 0.001) in the large aneurysm group. These findings may inform treatment decisions and patient counseling. Future studies are needed to further explore this area.

Keywords: Aneurysms; Intracranial; Treatment; WEB; Woven EndoBridge.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1**
Flowchart shows the inclusion for patients and aneurysms in this study

**Fig. 2**
ROC curve analyses for aneurysmal size in relation to retreatment rate

See this image and copyright information in PMC

References

1. Chalouhi N, Tjoumakaris S, Gonzalez LF et al (2014) Coiling of large and giant aneurysms: complications and long-term results of 334 cases. AJNR Am J Neuroradiol 35(3):546–552. 10.3174/ajnr.A3696 - PMC - PubMed
1. UCAS Japan Investigators, Morita A, Kirino T et al (2012) The natural course of unruptured cerebral aneurysms in a Japanese cohort. N Engl J Med. 366(26):2474–2482. 10.1056/NEJMoa1113260 - PubMed
1. Sundt TM, Piepgras DG (1979) Surgical approach to giant intracranial aneurysms. Operative experience with 80 cases. J Neurosurg. 51(6):731–742. 10.3171/jns.1979.51.6.0731 - PubMed
1. Kalani MYS, Zabramski JM, Hu YC, Spetzler RF (2013) Extracranial-intracranial bypass and vessel occlusion for the treatment of unclippable giant middle cerebral artery aneurysms. Neurosurgery 72(3):428–435; discussion 435–436. 10.1227/NEU.0b013e3182804381 - PubMed
1. van Rooij WJ, Sluzewski M (2009) Endovascular treatment of large and giant aneurysms. AJNR Am J Neuroradiol 30(1):12–18. 10.3174/ajnr.A1267 - PMC - PubMed

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Treatment of large intracranial aneurysms using the Woven EndoBridge (WEB): a propensity score-matched analysis

Affiliations

Treatment of large intracranial aneurysms using the Woven EndoBridge (WEB): a propensity score-matched analysis

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical