Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score-matched study

Mahmoud Dibas; Nimer Adeeb; Jose Danilo Bengzon Diestro; Hugo H. Cuellar; Ahmad Sweid; Sovann V. Lay; Adrien Guenego; Assala Aslan; Leonardo Renieri; Sri Hari Sundararajan; Guillaume Saliou; Markus Möhlenbruch; Robert W. Regenhardt; Justin E. Vranic; Ivan Lylyk; Paul M. Foreman; Jay A. Vachhani; Vedran Župančić; Muhammad U. Hafeez; Caleb Rutledge; Muhammad Waqas; Vincent M. Tutino; James D. Rabinov; Yifan Ren; Clemens M. Schirmer; Mariangela Piano; Anna L. Kühn; Caterina Michelozzi; Stéphanie Elens; Robert M. Starke; Ameer E. Hassan; Arsalaan Salehani; Peter Sporns; Jesse Jones; Marios Psychogios; Julian Spears; Boris Lubicz; Pietro Panni; Ajit S. Puri; Guglielmo Pero; Christoph J. Griessenauer; Hamed Asadi; Christopher J. Stapleton; Adnan Siddiqui; Andrew F. Ducruet; Felipe C. Albuquerque; Peter Kan; Vladimir Kalousek; Pedro Lylyk; Srikanth Boddu; Jared Knopman; Mohammad A. Aziz-Sultan; Nicola Limbucci; Pascal Jabbour; Christophe Cognard; Aman B. Patel; Adam A. Dmytriw

doi:10.3171/2021.12.JNS212293

Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score-matched study

Mahmoud Dibas, Nimer Adeeb, Jose Danilo Bengzon Diestro, Hugo H. Cuellar, Ahmad Sweid, Sovann V. Lay, Adrien Guenego, Assala Aslan, Leonardo Renieri, Sri Hari Sundararajan, Guillaume Saliou, Markus Möhlenbruch, Robert W. Regenhardt, Justin E. Vranic, Ivan Lylyk, Paul M. Foreman, Jay A. Vachhani, Vedran Župančić, Muhammad U. Hafeez, Caleb RutledgeMuhammad Waqas, Vincent M. Tutino, James D. Rabinov, Yifan Ren, Clemens M. Schirmer, Mariangela Piano, Anna L. Kühn, Caterina Michelozzi, Stéphanie Elens, Robert M. Starke, Ameer E. Hassan, Arsalaan Salehani, Peter Sporns, Jesse Jones, Marios Psychogios, Julian Spears, Boris Lubicz, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Christoph J. Griessenauer, Hamed Asadi, Christopher J. Stapleton, Adnan Siddiqui, Andrew F. Ducruet, Felipe C. Albuquerque, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Jared Knopman, Mohammad A. Aziz-Sultan, Nicola Limbucci, Pascal Jabbour, Christophe Cognard, Aman B. Patel, Adam A. Dmytriw

Neurology

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

Abstract

OBJECTIVE Transradial access (TRA) is commonly utilized in neurointerventional procedures. This study compared the technical and clinical outcomes of the use of TRA versus those of transfemoral access (TFA) for intracranial aneurysm embolization with the Woven EndoBridge (WEB) device. METHODS This is a secondary analysis of the Worldwide WEB Consortium, which comprises multicenter data related to adult patients with intracranial aneurysms who were managed with the WEB device. These aneurysms were categorized into two groups: those who were treated with TRA or TFA. Patient and aneurysm characteristics and technical and clinical outcomes were compared between groups. Propensity score matching (PSM) was used to match groups according to the following baseline characteristics: age, sex, subarachnoid hemorrhage, aneurysm location, bifurcation aneurysm, aneurysm with incorporated branch, neck width, aspect ratio, dome width, and elapsed time since the last follow-up imaging evaluation. RESULTS This study included 682 intracranial aneurysms (median [interquartile range] age 61.3 [53.0-68.0] years), of which 561 were treated with TFA and 121 with TRA. PSM resulted in 65 matched pairs. After PSM, both groups had similar characteristics, angiographic and functional outcomes, and rates of retreatment, thromboembolic and hemorrhagic complications, and death. TFA was associated with longer procedure length (median 96.5 minutes vs 72.0 minutes, p = 0.006) and fluoroscopy time (28.2 minutes vs 24.8 minutes, p = 0.037) as compared with TRA. On the other hand, deployment issues were more common in those treated with TRA, but none resulted in permanent complications. CONCLUSIONS TRA has comparable outcomes, with shorter procedure and fluoroscopy time, to TFA for aneurysm embolization with the WEB device.

Original language	English (US)
Pages (from-to)	1064-1071
Number of pages	8
Journal	Journal of neurosurgery
Volume	137
Issue number	4
DOIs	https://doi.org/10.3171/2021.12.JNS212293
State	Published - Oct 2022

Keywords

WEB
Woven EndoBridge
access
intracranial aneurysm
transfemoral
transradial
vascular disorders

ASJC Scopus subject areas

Surgery
Clinical Neurology

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10.3171/2021.12.JNS212293

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Dibas, M., Adeeb, N., Diestro, J. D. B., Cuellar, H. H., Sweid, A., Lay, S. V., Guenego, A., Aslan, A., Renieri, L., Sundararajan, S. H., Saliou, G., Möhlenbruch, M., Regenhardt, R. W., Vranic, J. E., Lylyk, I., Foreman, P. M., Vachhani, J. A., Župančić, V., Hafeez, M. U., ... Dmytriw, A. A. (2022). Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score-matched study. Journal of neurosurgery, 137(4), 1064-1071. https://doi.org/10.3171/2021.12.JNS212293

Dibas, M, Adeeb, N, Diestro, JDB, Cuellar, HH, Sweid, A, Lay, SV, Guenego, A, Aslan, A, Renieri, L, Sundararajan, SH, Saliou, G, Möhlenbruch, M, Regenhardt, RW, Vranic, JE, Lylyk, I, Foreman, PM, Vachhani, JA, Župančić, V, Hafeez, MU, Rutledge, C, Waqas, M, Tutino, VM, Rabinov, JD, Ren, Y, Schirmer, CM, Piano, M, Kühn, AL, Michelozzi, C, Elens, S, Starke, RM, Hassan, AE, Salehani, A, Sporns, P, Jones, J, Psychogios, M, Spears, J, Lubicz, B, Panni, P, Puri, AS, Pero, G, Griessenauer, CJ, Asadi, H, Stapleton, CJ, Siddiqui, A, Ducruet, AF, Albuquerque, FC, Kan, P, Kalousek, V, Lylyk, P, Boddu, S, Knopman, J, Aziz-Sultan, MA, Limbucci, N, Jabbour, P, Cognard, C, Patel, AB & Dmytriw, AA 2022, 'Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score-matched study', Journal of neurosurgery, vol. 137, no. 4, pp. 1064-1071. https://doi.org/10.3171/2021.12.JNS212293

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title = "Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score-matched study",

abstract = "OBJECTIVE Transradial access (TRA) is commonly utilized in neurointerventional procedures. This study compared the technical and clinical outcomes of the use of TRA versus those of transfemoral access (TFA) for intracranial aneurysm embolization with the Woven EndoBridge (WEB) device. METHODS This is a secondary analysis of the Worldwide WEB Consortium, which comprises multicenter data related to adult patients with intracranial aneurysms who were managed with the WEB device. These aneurysms were categorized into two groups: those who were treated with TRA or TFA. Patient and aneurysm characteristics and technical and clinical outcomes were compared between groups. Propensity score matching (PSM) was used to match groups according to the following baseline characteristics: age, sex, subarachnoid hemorrhage, aneurysm location, bifurcation aneurysm, aneurysm with incorporated branch, neck width, aspect ratio, dome width, and elapsed time since the last follow-up imaging evaluation. RESULTS This study included 682 intracranial aneurysms (median [interquartile range] age 61.3 [53.0-68.0] years), of which 561 were treated with TFA and 121 with TRA. PSM resulted in 65 matched pairs. After PSM, both groups had similar characteristics, angiographic and functional outcomes, and rates of retreatment, thromboembolic and hemorrhagic complications, and death. TFA was associated with longer procedure length (median 96.5 minutes vs 72.0 minutes, p = 0.006) and fluoroscopy time (28.2 minutes vs 24.8 minutes, p = 0.037) as compared with TRA. On the other hand, deployment issues were more common in those treated with TRA, but none resulted in permanent complications. CONCLUSIONS TRA has comparable outcomes, with shorter procedure and fluoroscopy time, to TFA for aneurysm embolization with the WEB device.",

keywords = "WEB, Woven EndoBridge, access, intracranial aneurysm, transfemoral, transradial, vascular disorders",

author = "Mahmoud Dibas and Nimer Adeeb and Diestro, {Jose Danilo Bengzon} and Cuellar, {Hugo H.} and Ahmad Sweid and Lay, {Sovann V.} and Adrien Guenego and Assala Aslan and Leonardo Renieri and Sundararajan, {Sri Hari} and Guillaume Saliou and Markus M{\"o}hlenbruch and Regenhardt, {Robert W.} and Vranic, {Justin E.} 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 Muhammad Waqas and Tutino, {Vincent M.} and Rabinov, {James D.} and Yifan Ren and Schirmer, {Clemens M.} 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 Peter Sporns and Jesse Jones and Marios Psychogios and Julian Spears and Boris Lubicz and Pietro Panni and Puri, {Ajit S.} and Guglielmo Pero and Griessenauer, {Christoph J.} and Hamed Asadi and Stapleton, {Christopher J.} and Adnan Siddiqui and Ducruet, {Andrew F.} and Albuquerque, {Felipe C.} and Peter Kan and Vladimir Kalousek and Pedro Lylyk and Srikanth Boddu and Jared Knopman and Aziz-Sultan, {Mohammad A.} and Nicola Limbucci and Pascal Jabbour and Christophe Cognard and Patel, {Aman B.} and Dmytriw, {Adam A.}",

note = "Publisher Copyright: {\textcopyright} AANS 2022.",

year = "2022",

month = oct,

doi = "10.3171/2021.12.JNS212293",

language = "English (US)",

volume = "137",

pages = "1064--1071",

journal = "Journal of neurosurgery",

issn = "0022-3085",

publisher = "American Association of Neurological Surgeons",

number = "4",

}

TY - JOUR

T1 - Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device

T2 - a propensity score-matched study

AU - Dibas, Mahmoud

AU - Adeeb, Nimer

AU - Diestro, Jose Danilo Bengzon

AU - Cuellar, Hugo H.

AU - Sweid, Ahmad

AU - Lay, Sovann V.

AU - Guenego, Adrien

AU - Aslan, Assala

AU - Renieri, Leonardo

AU - Sundararajan, Sri Hari

AU - Saliou, Guillaume

AU - Möhlenbruch, Markus

AU - Regenhardt, Robert W.

AU - Vranic, Justin E.

AU - Lylyk, Ivan

AU - Foreman, Paul M.

AU - Vachhani, Jay A.

AU - Župančić, Vedran

AU - Hafeez, Muhammad U.

AU - Rutledge, Caleb

AU - Waqas, Muhammad

AU - Tutino, Vincent M.

AU - Rabinov, James D.

AU - Ren, Yifan

AU - Schirmer, Clemens M.

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 - Sporns, Peter

AU - Jones, Jesse

AU - Psychogios, Marios

AU - Spears, Julian

AU - Lubicz, Boris

AU - Panni, Pietro

AU - Puri, Ajit S.

AU - Pero, Guglielmo

AU - Griessenauer, Christoph J.

AU - Asadi, Hamed

AU - Stapleton, Christopher J.

AU - Siddiqui, Adnan

AU - Ducruet, Andrew F.

AU - Albuquerque, Felipe C.

AU - Kan, Peter

AU - Kalousek, Vladimir

AU - Lylyk, Pedro

AU - Boddu, Srikanth

AU - Knopman, Jared

AU - Aziz-Sultan, Mohammad A.

AU - Limbucci, Nicola

AU - Jabbour, Pascal

AU - Cognard, Christophe

AU - Patel, Aman B.

AU - Dmytriw, Adam A.

PY - 2022/10

Y1 - 2022/10

N2 - OBJECTIVE Transradial access (TRA) is commonly utilized in neurointerventional procedures. This study compared the technical and clinical outcomes of the use of TRA versus those of transfemoral access (TFA) for intracranial aneurysm embolization with the Woven EndoBridge (WEB) device. METHODS This is a secondary analysis of the Worldwide WEB Consortium, which comprises multicenter data related to adult patients with intracranial aneurysms who were managed with the WEB device. These aneurysms were categorized into two groups: those who were treated with TRA or TFA. Patient and aneurysm characteristics and technical and clinical outcomes were compared between groups. Propensity score matching (PSM) was used to match groups according to the following baseline characteristics: age, sex, subarachnoid hemorrhage, aneurysm location, bifurcation aneurysm, aneurysm with incorporated branch, neck width, aspect ratio, dome width, and elapsed time since the last follow-up imaging evaluation. RESULTS This study included 682 intracranial aneurysms (median [interquartile range] age 61.3 [53.0-68.0] years), of which 561 were treated with TFA and 121 with TRA. PSM resulted in 65 matched pairs. After PSM, both groups had similar characteristics, angiographic and functional outcomes, and rates of retreatment, thromboembolic and hemorrhagic complications, and death. TFA was associated with longer procedure length (median 96.5 minutes vs 72.0 minutes, p = 0.006) and fluoroscopy time (28.2 minutes vs 24.8 minutes, p = 0.037) as compared with TRA. On the other hand, deployment issues were more common in those treated with TRA, but none resulted in permanent complications. CONCLUSIONS TRA has comparable outcomes, with shorter procedure and fluoroscopy time, to TFA for aneurysm embolization with the WEB device.

AB - OBJECTIVE Transradial access (TRA) is commonly utilized in neurointerventional procedures. This study compared the technical and clinical outcomes of the use of TRA versus those of transfemoral access (TFA) for intracranial aneurysm embolization with the Woven EndoBridge (WEB) device. METHODS This is a secondary analysis of the Worldwide WEB Consortium, which comprises multicenter data related to adult patients with intracranial aneurysms who were managed with the WEB device. These aneurysms were categorized into two groups: those who were treated with TRA or TFA. Patient and aneurysm characteristics and technical and clinical outcomes were compared between groups. Propensity score matching (PSM) was used to match groups according to the following baseline characteristics: age, sex, subarachnoid hemorrhage, aneurysm location, bifurcation aneurysm, aneurysm with incorporated branch, neck width, aspect ratio, dome width, and elapsed time since the last follow-up imaging evaluation. RESULTS This study included 682 intracranial aneurysms (median [interquartile range] age 61.3 [53.0-68.0] years), of which 561 were treated with TFA and 121 with TRA. PSM resulted in 65 matched pairs. After PSM, both groups had similar characteristics, angiographic and functional outcomes, and rates of retreatment, thromboembolic and hemorrhagic complications, and death. TFA was associated with longer procedure length (median 96.5 minutes vs 72.0 minutes, p = 0.006) and fluoroscopy time (28.2 minutes vs 24.8 minutes, p = 0.037) as compared with TRA. On the other hand, deployment issues were more common in those treated with TRA, but none resulted in permanent complications. CONCLUSIONS TRA has comparable outcomes, with shorter procedure and fluoroscopy time, to TFA for aneurysm embolization with the WEB device.

KW - WEB

KW - Woven EndoBridge

KW - access

KW - intracranial aneurysm

KW - transfemoral

KW - transradial

KW - vascular disorders

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UR - http://www.scopus.com/inward/citedby.url?scp=85137449729&partnerID=8YFLogxK

U2 - 10.3171/2021.12.JNS212293

DO - 10.3171/2021.12.JNS212293

M3 - Article

C2 - 35120326

AN - SCOPUS:85137449729

SN - 0022-3085

VL - 137

SP - 1064

EP - 1071

JO - Journal of neurosurgery

JF - Journal of neurosurgery

IS - 4

ER -

Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score-matched study

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