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RT Journal Article
SR Electronic
T1 Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of a Multicenter Retrospective Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 906
OP 911
DO 10.3174/ajnr.A8324
VO 45
IS 7
A1 Mastorakos, Panagiotis
A1 Naamani, Kareem El
A1 Adeeb, Nimer
A1 Lan, Mathews
A1 Castiglione, James
A1 Khanna, Omaditya
A1 Ghosh, Ritam
A1 Bengzon Diestro, Jose Danilo
A1 Dibas, Mahmoud
A1 McLellan, Rachel M.
A1 Algin, Oktay
A1 Ghozy, Sherief
A1 Cancelliere, Nicole M.
A1 Aslan, Assala
A1 Cuellar-Saenz, Hugo H.
A1 Lay, Sovann V.
A1 Guenego, Adrien
A1 Renieri, Leonardo
A1 Carnevale, Joseph
A1 Saliou, Guillaume
A1 Shotar, Eimad
A1 Premat, Kevin
A1 Möhlenbruch, Markus
A1 Kral, Michael
A1 Vranic, Justin E.
A1 Chung, Charlotte
A1 Salem, Mohamed M.
A1 Lylyk, Ivan
A1 Foreman, Paul M.
A1 Vachhani, Jay A.
A1 Shaikh, Hamza
A1 Župančić, Vedran
A1 Hafeez, Muhammad U.
A1 Catapano, Joshua
A1 Waqas, Muhammad
A1 Tutino, Vincent M.
A1 Ibrahim, Mohamed K.
A1 Mohammed, Marwa A.
A1 Rabinov, James D.
A1 Ren, Yifan
A1 Schirmer, Clemens M.
A1 Piano, Mariangela
A1 Bullrich, Maria Bres
A1 Mayich, Michael
A1 Kühn, Anna L.
A1 Michelozzi, Caterina
A1 Elens, Stéphanie
A1 Starke, Robert M.
A1 Hassan, Ameer E.
A1 Ogilvie, Mark
A1 Nguyen, Anh
A1 Jones, Jesse
A1 Brinjikji, Waleed
A1 Psychogios, Marios
A1 Ulfert, Christian
A1 Spears, Julian
A1 Jankowitz, Brian T.
A1 Burkhardt, Jan-Karl
A1 Domingo, Ricardo A.
A1 Huynh, Thien
A1 Tawk, Rabih G.
A1 Lubicz, Boris
A1 Nawka, Marie T.
A1 Panni, Pietro
A1 Puri, Ajit S.
A1 Pero, Guglielmo
A1 Nossek, Erez
A1 Raz, Eytan
A1 Killer-Oberpfalzer, Monika
A1 Ozates, M. Ozgur
A1 Ayberk, Giyas
A1 Regenhardt, Robert W.
A1 Griessenauer, Christoph J.
A1 Asadi, Hamed
A1 Siddiqui, Adnan
A1 Ducruet, Andrew F.
A1 Albuquerque, Felipe C.
A1 Patel, Nirav J.
A1 Stapleton, Christopher J.
A1 Kan, Peter
A1 Kalousek, Vladimir
A1 Lylyk, Pedro
A1 Boddu, Srikanth
A1 Knopman, Jared
A1 Aziz-Sultan, Mohammad A.
A1 Clarençon, Frédéric
A1 Limbucci, Nicola
A1 Zanaty, Mario
A1 Martinez-Gutierrez, Juan Carlos
A1 Sheth, Sunil
A1 Spiegel, Gary
A1 Abbas, Rawad
A1 Amllay, Abdelaziz
A1 Tjoumakaris, Stavropoula I.
A1 Gooch, Michael R.
A1 Herial, Nabeel A.
A1 Rosenwasser, Robert H.
A1 Zarzour, Hekmat
A1 Schmidt, Richard F.
A1 Pereira, Vitor Mendes
A1 Patel, Aman B.
A1 Jabbour, Pascal M.
A1 Dmytriw, Adam A.
YR 2024
UL http://www.ajnr.org/content/45/7/906.abstract
AB BACKGROUND AND PURPOSE: Despite the numerous studies evaluating the occlusion rates of aneurysms following WEB embolization, there are limited studies identifying predictors of occlusion. Our purpose was to identify predictors of aneurysm occlusion and the need for retreatment.MATERIALS AND METHODS: This is a review of a prospectively maintained database across 30 academic institutions. We included patients with previously untreated cerebral aneurysms embolized using the WEB who had available intraprocedural data and long-term follow-up.RESULTS: We studied 763 patients with a mean age of 59.9 (SD, 11.7) years. Complete aneurysm occlusion was observed in 212/726 (29.2%) cases, and contrast stasis was observed in 485/537 (90.3%) of nonoccluded aneurysms. At the final follow-up, complete occlusion was achieved in 497/763 (65.1%) patients, and retreatment was required for 56/763 (7.3%) patients. On multivariable analysis, history of smoking, maximal aneurysm diameter, and the presence of an aneurysm wall branch were negative predictors of complete occlusion (OR, 0.5, 0.8, and 0.4, respectively). Maximal aneurysm diameter, the presence of an aneurysm wall branch, posterior circulation location, and male sex increase the chances of retreatment (OR, 1.2, 3.8, 3.0, and 2.3 respectively). Intraprocedural occlusion resulted in a 3-fold increase in the long-term occlusion rate and a 5-fold decrease in the retreatment rate (P &lt; .001), offering a specificity of 87% and a positive predictive value of 85% for long-term occlusion.CONCLUSIONS: Intraprocedural occlusion can be used to predict the chance of long-term aneurysm occlusion and the need for retreatment after embolization with a WEB device. Smoking, aneurysm size, and the presence of an aneurysm wall branch are associated with decreased chances of successful treatment.ROCreceiver operating characteristic