Stent-assisted Woven EndoBridge device for the treatment of intracranial aneurysms: an international multicenter study

Jose Danilo Bengzon Diestro; Mahmoud Dibas; Nimer Adeeb; Robert W. Regenhardt; Justin E. Vranic; Adrien Guenego; Sovann V. Lay; Leonardo Renieri; Ali Al Balushi; Eimad Shotar; Kévin Premat; Kareem El Namaani; Guillaume Saliou; Markus A. Möhlenbruch; Ivan Lylyk; Paul M. Foreman; Jay A. Vachhani; Vedran Župančić; Muhammad U. Hafeez; Caleb Rutledge; Hamid Rai; Vincent M. Tutino; Shervin Mirshahi; Sherief Ghozy; Pablo Harker; Naif M. Alotaibi; James D. Rabinov; Yifan Ren; Clemens M. Schirmer; Oded Goren; Mariangela Piano; Anna L. Kühn; Caterina Michelozzi; Stéphanie Elens; Robert M. Starke; Ameer E. Hassan; Arsalaan Salehani; Anh Nguyen; Jesse Jones; Marios Psychogios; Julian Spears; Thomas Marotta; Vitor Pereira; Carmen Parra-Fariñas; Maria Bres-Bullrich; Michael Mayich; Mohamed M. Salem; Jan Karl Burkhardt; Brian T. Jankowitz; Ricardo A. Domingo; Thien Huynh; Rabih Tawk; Christian Ulfert; Boris Lubicz; Pietro Panni; Ajit S. Puri; Guglielmo Pero; Christoph J. Griessenauer; Hamed Asadi; Adnan Siddiqui; Andrew F. Ducruet; Felipe C. Albuquerque; Nirav Patel; Peter Kan; Vladimir Kalousek; Pedro Lylyk; Srikanth Boddu; Christopher J. Stapleton; Jared Knopman; Pascal Jabbour; Stavropoula Tjoumakaris; Frédéric Clarençon; Nicola Limbucci; Mohammad A. Aziz-Sultan; Hugo H. Cuellar-Saenz; Christophe Cognard; Aman B. Patel; Adam A. Dmytriw

doi:10.3171/2023.8.JNS235

Stent-assisted Woven EndoBridge device for the treatment of intracranial aneurysms: an international multicenter study

Jose Danilo Bengzon Diestro, Mahmoud Dibas, Nimer Adeeb, Robert W. Regenhardt, Justin E. Vranic, Adrien Guenego, Sovann V. Lay, Leonardo Renieri, Ali Al Balushi, Eimad Shotar, Kévin Premat, Kareem El Namaani, Guillaume Saliou, Markus A. Möhlenbruch, Ivan Lylyk, Paul M. Foreman, Jay A. Vachhani, Vedran Župančić, Muhammad U. Hafeez, Caleb RutledgeHamid Rai, Vincent M. Tutino, Shervin Mirshahi, Sherief Ghozy, Pablo Harker, Naif M. Alotaibi, James D. Rabinov, Yifan Ren, Clemens M. Schirmer, Oded Goren, Mariangela Piano, Anna L. Kühn, Caterina Michelozzi, Stéphanie Elens, Robert M. Starke, Ameer E. Hassan, Arsalaan Salehani, Anh Nguyen, Jesse Jones, Marios Psychogios, Julian Spears, Thomas Marotta, Vitor Pereira, Carmen Parra-Fariñas, Maria Bres-Bullrich, Michael Mayich, Mohamed M. Salem, Jan Karl Burkhardt, Brian T. Jankowitz, Ricardo A. Domingo, Thien Huynh, Rabih Tawk, Christian Ulfert, Boris Lubicz, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Christoph J. Griessenauer, Hamed Asadi, Adnan Siddiqui, Andrew F. Ducruet, Felipe C. Albuquerque, Nirav Patel, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Christopher J. Stapleton, Jared Knopman, Pascal Jabbour, Stavropoula Tjoumakaris, Frédéric Clarençon, Nicola Limbucci, Mohammad A. Aziz-Sultan, Hugo H. Cuellar-Saenz, Christophe Cognard, Aman B. Patel, Adam A. Dmytriw

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for wide-necked bifurcation aneurysms. These aneurysms may require the use of a concomitant stent. The objective of this study was to determine the clinical and radiological outcomes of patients undergoing stent-assisted WEB treatment. In addition, the authors also sought to determine the predictors of a concomitant stent in aneurysms treated with the WEB device. METHODS The data for this study were taken from the WorldWideWEB Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups based on treatment: stent-assisted WEB and WEB device alone. The authors compared clinical and radiological outcomes of both groups. Univariable and multivariable binary logistic regression analyses were performed to determine factors that predispose to stent use. RESULTS The study included 691 intracranial aneurysms (31 with stents and 660 without stents) treated with the WEB device. The adequate occlusion status did not differ between the two groups at the latest follow-up (83.3% vs 85.6%, p = 0.915). Patients who underwent stenting had more thromboembolic (32.3% vs 6.5%, p < 0.001) and procedural (16.1% vs 3.0%, p < 0.001) complications. Aneurysms treated with a concomitant stent had wider necks, greater heights, and lower dome-to-neck ratios. Increasing neck size was the only significant predictor for stent use. CONCLUSIONS This study demonstrates that there is no difference in the degree of aneurysm occlusion between the two groups; however, complications were more frequent in the stent group. In addition, a wider aneurysm neck predisposes to stent assistance in WEB-treated aneurysms.

Original language	English (US)
Pages (from-to)	1071-1079
Number of pages	9
Journal	Journal of neurosurgery
Volume	140
Issue number	4
DOIs	https://doi.org/10.3171/2023.8.JNS235
State	Published - 2024

Keywords

WEB
Woven EndoBridge
aneurysm
neurointervention
outcomes
vascular disorders

ASJC Scopus subject areas

Surgery
Clinical Neurology

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10.3171/2023.8.JNS235

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Diestro, J. D. B., Dibas, M., Adeeb, N., Regenhardt, R. W., Vranic, J. E., Guenego, A., Lay, S. V., Renieri, L., Al Balushi, A., Shotar, E., Premat, K., El Namaani, K., Saliou, G., Möhlenbruch, M. A., Lylyk, I., Foreman, P. M., Vachhani, J. A., Župančić, V., Hafeez, M. U., ... Dmytriw, A. A. (2024). Stent-assisted Woven EndoBridge device for the treatment of intracranial aneurysms: an international multicenter study. Journal of neurosurgery, 140(4), 1071-1079. https://doi.org/10.3171/2023.8.JNS235

Diestro, JDB, Dibas, M, Adeeb, N, Regenhardt, RW, Vranic, JE, Guenego, A, Lay, SV, Renieri, L, Al Balushi, A, Shotar, E, Premat, K, El Namaani, K, Saliou, G, Möhlenbruch, MA, Lylyk, I, Foreman, PM, Vachhani, JA, Župančić, V, Hafeez, MU, Rutledge, C, Rai, H, Tutino, VM, Mirshahi, S, Ghozy, S, Harker, P, Alotaibi, NM, Rabinov, JD, Ren, Y, Schirmer, CM, Goren, O, Piano, M, Kühn, AL, Michelozzi, C, Elens, S, Starke, RM, Hassan, AE, Salehani, A, Nguyen, A, Jones, J, Psychogios, M, Spears, J, Marotta, T, Pereira, V, Parra-Fariñas, C, Bres-Bullrich, M, Mayich, M, Salem, MM, Burkhardt, JK, Jankowitz, BT, Domingo, RA, Huynh, T, Tawk, R, Ulfert, C, Lubicz, B, Panni, P, Puri, AS, Pero, G, Griessenauer, CJ, Asadi, H, Siddiqui, A, Ducruet, AF, Albuquerque, FC, Patel, N, Kan, P, Kalousek, V, Lylyk, P, Boddu, S, Stapleton, CJ, Knopman, J, Jabbour, P, Tjoumakaris, S, Clarençon, F, Limbucci, N, Aziz-Sultan, MA, Cuellar-Saenz, HH, Cognard, C, Patel, AB & Dmytriw, AA 2024, 'Stent-assisted Woven EndoBridge device for the treatment of intracranial aneurysms: an international multicenter study', Journal of neurosurgery, vol. 140, no. 4, pp. 1071-1079. https://doi.org/10.3171/2023.8.JNS235

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title = "Stent-assisted Woven EndoBridge device for the treatment of intracranial aneurysms: an international multicenter study",

abstract = "OBJECTIVE The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for wide-necked bifurcation aneurysms. These aneurysms may require the use of a concomitant stent. The objective of this study was to determine the clinical and radiological outcomes of patients undergoing stent-assisted WEB treatment. In addition, the authors also sought to determine the predictors of a concomitant stent in aneurysms treated with the WEB device. METHODS The data for this study were taken from the WorldWideWEB Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups based on treatment: stent-assisted WEB and WEB device alone. The authors compared clinical and radiological outcomes of both groups. Univariable and multivariable binary logistic regression analyses were performed to determine factors that predispose to stent use. RESULTS The study included 691 intracranial aneurysms (31 with stents and 660 without stents) treated with the WEB device. The adequate occlusion status did not differ between the two groups at the latest follow-up (83.3% vs 85.6%, p = 0.915). Patients who underwent stenting had more thromboembolic (32.3% vs 6.5%, p < 0.001) and procedural (16.1% vs 3.0%, p < 0.001) complications. Aneurysms treated with a concomitant stent had wider necks, greater heights, and lower dome-to-neck ratios. Increasing neck size was the only significant predictor for stent use. CONCLUSIONS This study demonstrates that there is no difference in the degree of aneurysm occlusion between the two groups; however, complications were more frequent in the stent group. In addition, a wider aneurysm neck predisposes to stent assistance in WEB-treated aneurysms.",

keywords = "WEB, Woven EndoBridge, aneurysm, neurointervention, outcomes, vascular disorders",

author = "Diestro, {Jose Danilo Bengzon} and Mahmoud Dibas and Nimer Adeeb and Regenhardt, {Robert W.} and Vranic, {Justin E.} and Adrien Guenego and Lay, {Sovann V.} and Leonardo Renieri and {Al Balushi}, Ali and Eimad Shotar and K{\'e}vin Premat and {El Namaani}, Kareem and Guillaume Saliou and M{\"o}hlenbruch, {Markus A.} and Ivan Lylyk and Foreman, {Paul M.} and Vachhani, {Jay A.} and Vedran {\v Z}upan{\v c}i{\'c} and Hafeez, {Muhammad U.} and Caleb Rutledge and Hamid Rai and Tutino, {Vincent M.} and Shervin Mirshahi and Sherief Ghozy and Pablo Harker and Alotaibi, {Naif M.} and Rabinov, {James D.} and Yifan Ren and Schirmer, {Clemens M.} and Oded Goren and Mariangela Piano and K{\"u}hn, {Anna L.} and Caterina Michelozzi and St{\'e}phanie Elens and Starke, {Robert M.} and Hassan, {Ameer E.} and Arsalaan Salehani and Anh Nguyen and Jesse Jones and Marios Psychogios and Julian Spears and Thomas Marotta and Vitor Pereira and Carmen Parra-Fari{\~n}as and Maria Bres-Bullrich and Michael Mayich and Salem, {Mohamed M.} and Burkhardt, {Jan Karl} and Jankowitz, {Brian T.} and Domingo, {Ricardo A.} and Thien Huynh and Rabih Tawk and Christian Ulfert and Boris Lubicz and Pietro Panni and Puri, {Ajit S.} and Guglielmo Pero and Griessenauer, {Christoph J.} and Hamed Asadi and Adnan Siddiqui and Ducruet, {Andrew F.} and Albuquerque, {Felipe C.} and Nirav Patel and Peter Kan and Vladimir Kalousek and Pedro Lylyk and Srikanth Boddu and Stapleton, {Christopher J.} and Jared Knopman and Pascal Jabbour and Stavropoula Tjoumakaris and Fr{\'e}d{\'e}ric Claren{\c c}on and Nicola Limbucci and Aziz-Sultan, {Mohammad A.} and Cuellar-Saenz, {Hugo H.} and Christophe Cognard and Patel, {Aman B.} and Dmytriw, {Adam A.}",

note = "Publisher Copyright: {\textcopyright} AANS 2024, except where prohibited by US copyright law.",

year = "2024",

doi = "10.3171/2023.8.JNS235",

language = "English (US)",

volume = "140",

pages = "1071--1079",

journal = "Journal of neurosurgery",

issn = "0022-3085",

publisher = "American Association of Neurological Surgeons",

number = "4",

}

TY - JOUR

T1 - Stent-assisted Woven EndoBridge device for the treatment of intracranial aneurysms

T2 - an international multicenter study

AU - Diestro, Jose Danilo Bengzon

AU - Dibas, Mahmoud

AU - Adeeb, Nimer

AU - Regenhardt, Robert W.

AU - Vranic, Justin E.

AU - Guenego, Adrien

AU - Lay, Sovann V.

AU - Renieri, Leonardo

AU - Al Balushi, Ali

AU - Shotar, Eimad

AU - Premat, Kévin

AU - El Namaani, Kareem

AU - Saliou, Guillaume

AU - Möhlenbruch, Markus A.

AU - Lylyk, Ivan

AU - Foreman, Paul M.

AU - Vachhani, Jay A.

AU - Župančić, Vedran

AU - Hafeez, Muhammad U.

AU - Rutledge, Caleb

AU - Rai, Hamid

AU - Tutino, Vincent M.

AU - Mirshahi, Shervin

AU - Ghozy, Sherief

AU - Harker, Pablo

AU - Alotaibi, Naif M.

AU - Rabinov, James D.

AU - Ren, Yifan

AU - Schirmer, Clemens M.

AU - Goren, Oded

AU - Piano, Mariangela

AU - Kühn, Anna L.

AU - Michelozzi, Caterina

AU - Elens, Stéphanie

AU - Starke, Robert M.

AU - Hassan, Ameer E.

AU - Salehani, Arsalaan

AU - Nguyen, Anh

AU - Jones, Jesse

AU - Psychogios, Marios

AU - Spears, Julian

AU - Marotta, Thomas

AU - Pereira, Vitor

AU - Parra-Fariñas, Carmen

AU - Bres-Bullrich, Maria

AU - Mayich, Michael

AU - Salem, Mohamed M.

AU - Burkhardt, Jan Karl

AU - Jankowitz, Brian T.

AU - Domingo, Ricardo A.

AU - Huynh, Thien

AU - Tawk, Rabih

AU - Ulfert, Christian

AU - Lubicz, Boris

AU - Panni, Pietro

AU - Puri, Ajit S.

AU - Pero, Guglielmo

AU - Griessenauer, Christoph J.

AU - Asadi, Hamed

AU - Siddiqui, Adnan

AU - Ducruet, Andrew F.

AU - Albuquerque, Felipe C.

AU - Patel, Nirav

AU - Kan, Peter

AU - Kalousek, Vladimir

AU - Lylyk, Pedro

AU - Boddu, Srikanth

AU - Stapleton, Christopher J.

AU - Knopman, Jared

AU - Jabbour, Pascal

AU - Tjoumakaris, Stavropoula

AU - Clarençon, Frédéric

AU - Limbucci, Nicola

AU - Aziz-Sultan, Mohammad A.

AU - Cuellar-Saenz, Hugo H.

AU - Cognard, Christophe

AU - Patel, Aman B.

AU - Dmytriw, Adam A.

PY - 2024

Y1 - 2024

N2 - OBJECTIVE The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for wide-necked bifurcation aneurysms. These aneurysms may require the use of a concomitant stent. The objective of this study was to determine the clinical and radiological outcomes of patients undergoing stent-assisted WEB treatment. In addition, the authors also sought to determine the predictors of a concomitant stent in aneurysms treated with the WEB device. METHODS The data for this study were taken from the WorldWideWEB Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups based on treatment: stent-assisted WEB and WEB device alone. The authors compared clinical and radiological outcomes of both groups. Univariable and multivariable binary logistic regression analyses were performed to determine factors that predispose to stent use. RESULTS The study included 691 intracranial aneurysms (31 with stents and 660 without stents) treated with the WEB device. The adequate occlusion status did not differ between the two groups at the latest follow-up (83.3% vs 85.6%, p = 0.915). Patients who underwent stenting had more thromboembolic (32.3% vs 6.5%, p < 0.001) and procedural (16.1% vs 3.0%, p < 0.001) complications. Aneurysms treated with a concomitant stent had wider necks, greater heights, and lower dome-to-neck ratios. Increasing neck size was the only significant predictor for stent use. CONCLUSIONS This study demonstrates that there is no difference in the degree of aneurysm occlusion between the two groups; however, complications were more frequent in the stent group. In addition, a wider aneurysm neck predisposes to stent assistance in WEB-treated aneurysms.

AB - OBJECTIVE The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for wide-necked bifurcation aneurysms. These aneurysms may require the use of a concomitant stent. The objective of this study was to determine the clinical and radiological outcomes of patients undergoing stent-assisted WEB treatment. In addition, the authors also sought to determine the predictors of a concomitant stent in aneurysms treated with the WEB device. METHODS The data for this study were taken from the WorldWideWEB Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups based on treatment: stent-assisted WEB and WEB device alone. The authors compared clinical and radiological outcomes of both groups. Univariable and multivariable binary logistic regression analyses were performed to determine factors that predispose to stent use. RESULTS The study included 691 intracranial aneurysms (31 with stents and 660 without stents) treated with the WEB device. The adequate occlusion status did not differ between the two groups at the latest follow-up (83.3% vs 85.6%, p = 0.915). Patients who underwent stenting had more thromboembolic (32.3% vs 6.5%, p < 0.001) and procedural (16.1% vs 3.0%, p < 0.001) complications. Aneurysms treated with a concomitant stent had wider necks, greater heights, and lower dome-to-neck ratios. Increasing neck size was the only significant predictor for stent use. CONCLUSIONS This study demonstrates that there is no difference in the degree of aneurysm occlusion between the two groups; however, complications were more frequent in the stent group. In addition, a wider aneurysm neck predisposes to stent assistance in WEB-treated aneurysms.

KW - WEB

KW - Woven EndoBridge

KW - aneurysm

KW - neurointervention

KW - outcomes

KW - vascular disorders

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DO - 10.3171/2023.8.JNS235

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SN - 0022-3085

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JO - Journal of neurosurgery

JF - Journal of neurosurgery

IS - 4

ER -

Stent-assisted Woven EndoBridge device for the treatment of intracranial aneurysms: an international multicenter study

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