Factors that determine aneurysm occlusion after embolization with the Woven EndoBridge (WEB)

Kabbasch, Christoph; Goertz, Lukas; Siebert, Eberhard; Herzberg, Moriz; Borggrefe, Jan; Dorn, Franziska; Liebig, Thomas

doi:10.1136/neurintsurg-2018-014361

Cited by 39 publications

(30 citation statements)

References 31 publications

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“…However, more stubborn challenges remain, such as the endovascular management of wide-necked bifurcation aneurysms. In their mid-term analysis of 98 patients treated with the WEB device, Kabbasch et al report an 83.7% rate of adequate aneurysm occlusion 9. These results compare favorably with previously established techniques, such as stent-assisted coiling, and are concordant with the 12-month results of the WEB-IT study, which also documented an excellent safety profile of the device 10–12.…”

supporting

confidence: 56%

Better is Good

Albuquerque

2019

J NeuroIntervent Surg

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supporting

confidence: 56%

Better is Good

Albuquerque

2019

J NeuroIntervent Surg

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“…The Woven EndoBridge (WEB) device is an intra-aneurysmal flow disruptor that was designed for the treatment of wide-necked bifurcation aneurysms. 19,20 However, the morphology of some aneurysms may not be appropriate for successful treatment with WEB implantation. Previous studies showed that the after WEB implantation, aneurysm occlusion rates were dependent on the size and morphology of the aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Y-Stent-Assisted Coiling With Low-Profile Neuroform Atlas Stents for Endovascular Treatment of Wide-Necked Complex Intracranial Bifurcation Aneurysms

et al. 2019

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BACKGROUND Y-stent-assisted coiling is one of the eligible techniques for the treatment of complex bifurcation aneurysms. In majority of previous literature, Y-stenting has been performed using stents that could be delivered through large profile microcatheters that are often difficult to manipulate during navigation through sharply angled side branches. Attempts to navigate with these large profile catheters might cause serious complications during Y-stenting procedure. OBJECTIVE To investigate the safety, feasibility, and efficacy of Y-stent-assisted coiling procedure with Neuroform Atlas stents for the treatment of complex bifurcation aneurysms; Neuroform Atlas is a recently introduced open-cell stent that can be delivered though low-profile microcatheters. METHODS We identified the patients with intracranial bifurcation aneurysms treated by Y-stent-assisted coiling procedure with Neuroform Atlas stents. We assessed the immediate postoperative and follow-up clinical and angiographic outcomes. We also investigated the periprocedural and delayed complications. RESULTS A total of 30 aneurysms in 30 patients were included in the study. Y-stenting was successfully performed without any technical complications in all cases (100%). Immediate postprocedural angiography revealed total aneurysm occlusion in 83.3% of patients. The mean angiographic follow-up time was 11.8 mo. The last follow-ups showed complete occlusion in 93.3% of patients. There was no mortality in this study. A procedure-related complication developed in 6.7% and resulted in permanent morbidity in 3.3% of patients. CONCLUSION Neuroform Atlas stent combines the advantages of low-profile deployment microcatheters with an open-cell structure to achieve a successful Y-stenting procedure. Y-stent-assisted coiling with Neuroform Atlas stents provides a safe and effective endovascular treatment for wide-necked complex bifurcation aneurysms.

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“…Consistent with the literature of WEB devices reporting 80% adequate occlusion at 1 year, 3,9 in our series, RR 1/RR 2 occlusion was 79% and 81% after 12-and 24-month DSA follow-up. Kabbasch et al, 10 evaluating a series of 98 aneurysms treated with the WEB, reported dome size, intra-aneurysmal thrombosis, and additional coiling as factors associated with lower occlusion at 6-month follow-up. Another recent series of 24 aneurysms reported that ostium size and dome-to-ostium ratio were significantly related to the angiographic results after WEB treatment.…”

Section: Predictors Of Angiographic Occlusionmentioning

confidence: 99%

Predicting Factors of Angiographic Aneurysm Occlusion after Treatment with the Woven EndoBridge Device: A Single-Center Experience with Midterm Follow-Up

Cagnazzo

Ahmed

Zannoni

et al. 2019

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Flow disruption with the Woven EndoBridge is increasingly used for the treatment of intracranial aneurysms. We examined factors leading to aneurysm occlusion and Woven EndoBridge shape change during a midterm follow-up. MATERIALS AND METHODS: Patients with a minimum 12-month angiographic follow-up were included. Through a univariate and multivariate analysis, independent predictors of adequate occlusion (Raymond-Roy 1/Raymond-Roy 2) and Woven EndoBridge shape change (decrease of the height of the device) were assessed. RESULTS: Eighty-six patients/aneurysms were included. The aneurysm mean size was 5.5 mm (range, 3-11.5 mm). The most common locations were the MCA (43/86 ¼ 50%), basilar tip (13/86 ¼ 15.1%), and anterior communicating artery (12/86 = 14%). Twenty-one patients (21/86 ¼ 24%) had acute SAH. Immediate and long-term Raymond-Roy 1/Raymond-Roy 2 occlusion rates were 49% (42/86) and 80% (68/86), respectively. Woven EndoBridge shape change was detected among 22% (19/86) of cases. At binary logistic regression, wide ostium ($4 mm) (OR ¼ 0.2; 95% CI, 0.01-1; P ¼ .04) and regular aneurysm morphology (OR ¼ 5.9; 95% CI, 1.4-24; P ¼ .01) were independent factors of incomplete and adequate aneurysm occlusion, respectively. In addition, irregular morphology (OR = 5.4; 95%CI , 1.4-19; P ¼ .01) and a wide ostium (OR ¼ 9.8; 95% CI, 1.6-60; P ¼ .03) significantly increased the probability of the Woven EndoBridge shape change. Decrease of the Woven EndoBridge height was more common among incompletely occluded aneurysms (6/12 ¼ 50% versus 13/74 ¼ 17.5%), but it was not an independent prognosticator of occlusion at the multivariate model. CONCLUSIONS: The likelihood of good occlusion was 5 times lower in the presence of a wide ostium, whereas aneurysms with regular morphology were 6 times more likely to be occluded. Woven EndoBridge shape modification was strongly influenced by the aneurysm shape and ostium size, and it was not independently associated with the angiographic occlusion.

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Factors that determine aneurysm occlusion after embolization with the Woven EndoBridge (WEB)

Cited by 39 publications

References 31 publications

Better is Good

Better is Good

Y-Stent-Assisted Coiling With Low-Profile Neuroform Atlas Stents for Endovascular Treatment of Wide-Necked Complex Intracranial Bifurcation Aneurysms

Predicting Factors of Angiographic Aneurysm Occlusion after Treatment with the Woven EndoBridge Device: A Single-Center Experience with Midterm Follow-Up

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