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Multicenter Study
. 2025 Jan 31;142(6):1732-1740.
doi: 10.3171/2024.10.JNS241058. Print 2025 Jun 1.

Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study

Dhrumil Vaishnav  1 , Muhammed Amir Essibayi  1 , Basel Musmar  2 , Nimer Adeeb  2 , Hamza Adel Salim  2 , Assala Aslan  2 , Nicole M Cancelliere  3 , Rachel M McLellan  4 , Oktay Algin  5 , Sherief Ghozy  6 , Sovann V Lay  7 , Adrien Guenego  8 , Leonardo Renieri  9 , Joseph Carnevale  10 , Guillaume Saliou  11 , Panagiotis Mastorakos  12 , Kareem El Naamani  12 , Eimad Shotar  13 , Kevin Premat  13 , Markus Möhlenbruch  14 , Michael Kral  15 , Omer Doron  4 , Charlotte Chung  16 , Mohamed M Salem  17 , Ivan Lylyk  18 , Paul M Foreman  19 , Jay A Vachhani  20 , Hamza Shaikh  21 , Vedran Župančić  22 , Muhammad U Hafeez  23 , Joshua Catapano  24 , Muhammad Waqas  24 , Giyas Ayberk  5 , Yasin Celal Gunes  7 , James D Rabinov  4 , Yifan Ren  25 , Clemens M Schirmer  26 , Mariangela Piano  27 , Anna L Kühn  28 , Caterina Michelozzi  29 , Stéphanie Elens  8 , Robert M Starke  30 , Ameer E Hassan  31 , Mark Ogilvie  32 , Anh Nguyen  33 , Jesse Jones  32 , Waleed Brinjikji  6 , Marie T Nawka  34 , Marios Psychogios  33 , Christian Ulfert  14 , Jose Danilo Bengzon Diestro  3 , Bryan Pukenas  17 , Jan-Karl Burkhardt  17 , Thien Huynh  35 , Juan Carlos Martinez-Gutierrez  36 , Sunil A Sheth  36 , Gary Spiegel  36 , Rabih G Tawk  35 , Boris Lubicz  8 , Pietro Panni  29 , Ajit S Puri  28 , Guglielmo Pero  27 , Erez Nossek  16 , Eytan Raz  16 , Monika Killer-Oberpfalzer  15 , Christoph J Griessenauer  15 , Hamed Asadi  16 , Adnan Siddiqui  24 , Allan L Brook  1 , Neil Haranhalli  1 , Andrew F Ducruet  23 , Felipe C Albuquerque  23 , Robert W Regenhardt  4 , Christopher J Stapleton  4 , Peter Kan  22 , Vladimir Kalousek  21 , Pedro Lylyk  18 , Srikanth Boddu  11 , Jared Knopman  11 , Mohammad A Aziz-Sultan  5 , Stavropoula I Tjoumakaris  12 , Frédéric Clarençon  13 , Nicola Limbucci  10 , Hugo H Cuellar-Saenz  2 , Pascal M Jabbour  12 , Vitor Mendes Pereira  4 , Aman B Patel  4 , David J Altschul  1 , Adam A Dmytriw  2   4 ; WorldWideWEB Consortium
Collaborators, Affiliations
Multicenter Study

Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study

Dhrumil Vaishnav et al. J Neurosurg. .

Abstract

Objective: Tobacco smoking is among the factors known to significantly augment the risk of untreated intracranial aneurysm (IA) growth and rupture. Smoking appears to have a variable effect on different endovascular treatment modalities. The impact of smoking on the safety, efficacy, and outcomes of Woven EndoBridge (WEB) device use for wide-neck IAs has not been evaluated. This study aimed to investigate the outcomes of WEB devices by smoking status.

Methods: A retrospective multicenter analysis was conducted on the data of patients from 36 sites worldwide treated with the WEB device for intracranial saccular aneurysms. Patients were stratified based on smoking status (current, former, and never smokers). The Student t-test and chi-square test were performed for continuous and categorical variables, respectively. Multivariable logistic regression was used to adjust for confounders.

Results: Of 1376 patients with available smoking status, 504 were current smokers, 358 were former smokers, and 514 were never smokers. Upon adjusting for significant confounders, no association was found between smoking and recurrence outcomes (OR 1.39, 95% CI 0.69-2.80; p = 0.36), thromboembolic and hemorrhagic complications, and mortality among IAs treated with the WEB device. There was no statistically significant difference in outcomes between former and never smokers (OR 1.23, 95% CI 0.70-2.18; p = 0.46). The location of aneurysms differed between smoking groups, with former smokers having more anterior circulation aneurysms compared with current and never smokers (99.0% vs 96.9% vs 95.3%; p = 0.01). In terms of clinical symptoms, headache and dizziness were more common in the never smokers compared with current and former smokers (13.9% vs 8.9% vs 7.7%, p = 0.01).

Conclusions: This large-scale study suggests no significant correlation between smoking and the recurrence of IAs treated with the WEB device. Biological studies are warranted to better understand the biological impact of smoking on the growth and rupture of treated IAs.

Keywords: WEB; Woven EndoBridge; aneurysms; intracranial; smoking; vascular disorders.

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