Comparing treatment outcomes of various intracranial bifurcation aneurysms locations using the Woven EndoBridge (WEB) device

Nimer Adeeb, Departments of Neurosurgery and Neurointerventional Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA nimer_adeeb@hotmail.com.
Mahmoud Dibas, Neuroradiology and Neurosurgical Services, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Jose Danilo Diestro, Department of Diagnostic and Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Kevin Phan, Neuroradiology and Neurosurgical Services, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Hugo H. Cuellar-Saenz, Departments of Neurosurgery and Neurointerventional Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Ahmad Sweid, Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Sovann V. Lay, Interventional Neuroradiology Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Adrien Guenego, Interventional Neuroradiology Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Assala Aslan, Departments of Neurosurgery and Neurointerventional Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Leonardo Renieri, Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy.
Sri Hari Sundararajan, Neurosurgery and Interventional Neuroradiology, New York Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York, USA.
Guillaume Saliou, Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland.
Markus Möhlenbruch, Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany.
Robert W. Regenhardt, Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Justin E. Vranic, Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Ivan Lylyk, Equipo de Neurocirugía Endovascular y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina.
Paul M. Foreman, Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA.
Jay A. Vachhani, Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA.
Vedran Župančić, Department of Radiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia.
Muhammad U. Hafeez, Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX.
Caleb Rutledge, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Muhammad Waqas, Department of Neurosurgery, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Vincent M. Tutino, Department of Neurosurgery, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
James D. Rabinov, Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Yifan Ren, Neurointervention Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia.
Clemens M. Schirmer, Departments of Neurosurgery and Radiology, Geisinger Hospital, Danville, Virginia, USA.
Mariangela Piano, Department of Neuroradiology, Ospedale Niguarda Ca' Granda, Milano, Italy.
Anna L. Kuhn, Department of Radiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Caterina Michelozzi, Interventistica Neurovascolare, Ospedale San Raffaele, Milano, Italy.
Stephanie Elens, Department of Interventional Neuroradiology, Erasmus Hospital, Bruxelles, Bruxelles, Belgium.
Robert M. Starke, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Ameer Hassan, Deparment of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, USA.

Document Type

Article

Abstract

BACKGROUND: The Woven EndoBridge (WEB) device has Food and Drug Administration approval for treatment of wide-necked intracranial bifurcation aneurysms. The WEB device has been shown to result in adequate occlusion in bifurcation aneurysms overall, but its usefulness in the individual bifurcation locations has been evaluated separately only in few case series, which were limited by small sample sizes. OBJECTIVE: To compare angiographic and clinical outcomes after treatment of bifurcation aneurysms at various locations, including anterior communicating artery (AComA), anterior cerebral artery (ACA) bifurcation distal to AComA, basilar tip, internal carotid artery (ICA) bifurcation, and middle cerebral artery (MCA) bifurcation aneurysms using the WEB device. METHODS: A retrospective cohort analysis was conducted at 22 academic institutions worldwide to compare treatment outcomes of patients with intracranial bifurcation aneurysms using the WEB device. Data include patient and aneurysm characteristics, procedural details, angiographic and functional outcomes, and complications. RESULTS: A total of 572 aneurysms were included. MCA (36%), AComA (35.7%), and basilar tip (18.9%) aneurysms were most common. The rate of adequate aneurysm occlusion was significantly higher for basilar tip (91.6%) and ICA bifurcation (96.7%) aneurysms and lower for ACA bifurcation (71.4%) and AComA (80.6%) aneurysms (p=0.04). CONCLUSION: To our knowledge, this is the most extensive study to date that compares the treatment of different intracranial bifurcation aneurysms using the WEB device. Basilar tip and ICA bifurcation aneurysms showed significantly higher rates of aneurysm occlusion than other locations.

Medical Subject Headings

Humans; Retrospective Studies; Embolization, Therapeutic; Endovascular Procedures; Treatment Outcome; Intracranial Aneurysm (diagnostic imaging, therapy); Carotid Artery Diseases (therapy)

Publication Date

6-1-2023

Publication Title

Journal of neurointerventional surgery

E-ISSN

1759-8486

Volume

15

Issue

6

First Page

558

Last Page

565

PubMed ID

35483912

Digital Object Identifier (DOI)

10.1136/neurintsurg-2022-018694

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