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Title: Long-Term Follow-Up of Cerebral Aneurysms Completely Occluded at 6 Months After Intervention with the Woven EndoBridge (WEB) Device: a Retrospective Multicenter Observational Study.
Austin Authors: El Naamani, Kareem;Mastorakos, Panagiotis;Adeeb, Nimer;Lan, Mathews;Castiglione, James;Khanna, Omaditya;Diestro, Jose Danilo Bengzon;McLellan, Rachel M;Dibas, Mahmoud;Vranic, Justin E;Aslan, Assala;Cuellar-Saenz, Hugo H;Guenego, Adrien;Carnevale, Joseph;Saliou, Guillaume;Ulfert, Christian;Möhlenbruch, Markus;Foreman, Paul M;Vachhani, Jay A;Hafeez, Muhammad U;Waqas, Muhammad;Tutino, Vincent M;Rabinov, James D;Ren, Yifan;Michelozzi, Caterina;Spears, Julian;Panni, Pietro;Griessenauer, Christoph J;Asadi, Hamed ;Regenhardt, Robert W;Stapleton, Christopher J;Ghozy, Sherief;Siddiqui, Adnan;Patel, Nirav J;Kan, Peter;Boddu, Srikanth;Knopman, Jared;Aziz-Sultan, Mohammad A;Zanaty, Mario;Ghosh, Ritam;Abbas, Rawad;Amllay, Abdelaziz;Tjoumakaris, Stavropoula I;Gooch, Michael R;Cancelliere, Nicole M;Herial, Nabeel A;Rosenwasser, Robert H;Zarzour, Hekmat;Schmidt, Richard F;Pereira, Vitor Mendes;Patel, Aman B;Jabbour, Pascal;Dmytriw, Adam A
Affiliation: Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Departement of Neurosurgery and Neurointerventional Surgery, Louisiana State University, Shreveport, LA, USA.
Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.;Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Service de Neuroradiologie Interventionnelle, Hôpital Universitaire Erasme, Brussels, Belgium.
Neurosurgery & Interventional Neuroradiology, Weill Cornell School of Medicine, New York Presbyterian Hospital, New York, NY, USA.
Service de Radiodiagnostic et Radiologie Interventionnelle, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland.
Sektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA.
Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA.
Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA.
Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milan, Italy.
Interventional Neuroradiology and Neurosurgery, San Raffaele University Hospital, Milan, Italy.
Department of Neurosurgery, Christian Doppler University Hospital, Paracelsus Medical University Salzburg, Salzburg, Austria.;Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
Issue Date: 11-May-2023
Date: 2023
Publication information: Translational Stroke Research 2023
Abstract: The Woven EndoBridge (WEB) device has been widely used to treat intracranial wide neck bifurcation aneurysms. Initial studies have demonstrated that approximately 90% of patients have same or improved long-term aneurysm occlusion after the initial 6-month follow up. The aim of this study is to assess the long-term follow-up in aneurysms that have achieved complete occlusion at 6 months. We also compared the predictive value of different imaging modalities used. This is an analysis of a prospectively maintained database across 13 academic institutions. We included patients with previously untreated cerebral aneurysms embolized using the WEB device who achieved complete occlusion at first follow-up and had available long-term follow-up. A total of 95 patients with a mean age of 61.6 ± 11.9 years were studied. The mean neck diameter and height were 3.9 ± 1.3 mm and 6.0 ± 1.8 mm, respectively. The mean time to first and last follow-up was 5.4 ± 1.8 and 14.1 ± 12.9 months, respectively. Out of all the aneurysms that were completely occluded at 6 months, 84 (90.3%) showed complete occlusion at the final follow-up, and 11(11.5%) patients did not achieve complete occlusion. The positive predictive value (PPV) of complete occlusion at first follow was 88.4%. Importantly, this did not differ between digital subtraction angiography (DSA), magnetic resonance angiography (MRA), or computed tomography angiography (CTA). This study underlines the importance of repeat imaging in patients treated with the WEB device even if complete occlusion is achieved short term. Follow-up can be performed using DSA, MRA or CTA with no difference in positive predictive value.
DOI: 10.1007/s12975-023-01153-5
Journal: Translational Stroke Research
PubMed URL: 37165289
ISSN: 1868-601X
Type: Journal Article
Subjects: Aneurysm
Positive predictive value
WEB device
Appears in Collections:Journal articles

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