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https://ahro.austin.org.au/austinjspui/handle/1/34960| Title: | The impact of postoperative aspirin in patients undergoing Woven EndoBridge: a multicenter, institutional, propensity score-matched analysis. | Austin Authors: | Dmytriw, Adam A;Musmar, Basel;Salim, Hamza;Aslan, Assala;Cancelliere, Nicole M;McLellan, Rachel M;Algin, Oktay;Ghozy, Sherief;Dibas, Mahmoud;Lay, Sovann V;Guenego, Adrien;Renieri, Leonardo;Carnevale, Joseph Anthony;Saliou, Guillaume;Mastorakos, Panagiotis;El Naamani, Kareem;Shotar, Eimad;Premat, Kevin;Möhlenbruch, Markus A;Kral, Michael;Doron, Omer;Chung, Charlotte;Salem, Mohamed M;Lylyk, Ivan;Foreman, Paul M;Vachhani, Jay A;Shaikh, Hamza;Župančić, Vedran;Hafeez, Muhammad Ubaid;Catapano, Joshua S;Waqas, Muhammad;Tutino, Vincent M;Ibrahim, Mohamed K;Mohammed, Marwa A;Imamoglu, Cetin;Bayrak, Ahmet;Rabinov, James D;Ren, Yifan;Schirmer, Clemens M;Piano, Mariangela;Kuhn, Anna Luisa;Michelozzi, Caterina;Elens, Stephanie;Hasan, Zuha;Starke, Robert M;Hassan, Ameer E;Ogilvie, Mark;Nguyen, Anh;Jones, Jesse;Brinjikji, Waleed;Nawka, Marie Teresa;Psychogios, Marios-Nikos;Ulfert, Christian;Diestro, Jose Danilo Bengzon;Pukenas, Bryan;Burkhardt, Jan Karl;Huynh, Thien J;Martinez-Gutierrez, Juan Carlos;Essibayi, Muhammed Amir;Sheth, Sunil A;Spiegel, Gary;Tawk, Rabih;Lubicz, Boris;Panni, Pietro;Puri, Ajit S;Pero, Guglielmo;Nossek, Erez;Raz, Eytan;Killer-Oberpfalzer, Monika;Griessenauer, Christoph J;Asadi, Hamed ;Siddiqui, Adnan H;Brook, Allan L;Altschul, David;Ducruet, Andrew F;Albuquerque, Felipe C;Regenhardt, Robert W;Stapleton, Christopher J;Kan, Peter;Kalousek, Vladimir;Lylyk, Pedro;Boddu, Srikanth Reddy;Knopman, Jared;Aziz-Sultan, Mohammad A;Tjoumakaris, Stavropoula I;Clarençon, Frédéric;Limbucci, Nicola;Cuellar, Hugo H;Jabbour, Pascal M;Pereira, Vitor M;Patel, Aman B;Adeeb, Nimer | Affiliation: | Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA. Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. Department of Radiology, Medical Faculty of Ankara University, Ankara, Turkey. Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA. Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA. Department of Neuroradiology, Centre Hospitalier de Toulouse, Toulouse, France. Department of Neuroradiology, Hôpital Universitaire Erasme, Bruxelles, Belgium. Department of Neuroradiology, Ospedale Careggi di Firenze, Florence, Italy. Department of Neurosurgery and Neuroradiology, New York Presbyterian Hospital and Weill Cornell School of Medicine, New York, NY, USA. Department of Neuroradiology, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland. Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Department of Neuroradiology, Hôpital Pitié-Salpêtrière, Paris, France. Department of Neuroradiology, Universitätsklinikum Heidelberg, Heidelberg, Germany. Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria. Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA. Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA. Department of Neuroradiology, Clínica La Sagrada Familia, Buenos Aires, Argentina. Department of Neurosurgery, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA. Departments of Radiology & Neurosurgery, Cooper University Health Care, Camden, NJ, USA. Department of Neuroradiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia. Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA. Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA. Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA. Department of Neuroradiology, Austin Health, Victoria, Victoria, Australia Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA. Department of Neuroradiology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey. Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Radiology Department of Neurosurgery and Radiology, Geisinger Hospital, Danville, PA, USA. Department of Neuroradiology, Ospedale Niguarda Cà Granda, Milano, Italy. Department of Neuroradiology, UMass Memorial Hospital, Worcester, MA, USA. Department of Neuroradiology, Ospedale San Raffaele, Milano, Italy. Department of Neuroradiology, Ospedale Careggi di Firenze, Florence, Italy. Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.;Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. Department of Neurosurgery, University of Miami, Miami, FL, USA. Department of Neuroradiology, Valley Baptist Neuroscience Institute, Harlingen, TX, USA. Deparments of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA. Department of Neuroradiology, University Hospital of Basel, Basel, Switzerland. Deparments of Neurosurgery and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA. Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA. Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Department of Neuroradiology, University Hospital of Basel, Basel, Switzerland. Department of Neuroradiology, Universitätsklinikum Heidelberg, Heidelberg, Germany. Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA. Departments of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA. Department of Neuroradiology, University of Texas Health Science Center at Houston, Houston, Texas, USA. Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. Department of Neuroradiology, University of Texas Health Science Center at Houston, Houston, Texas, USA. Departments of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA. Department of Neuroradiology, Ospedale Careggi di Firenze, Florence, Italy. Department of Neuroradiology, Ospedale San Raffaele, Milano, Italy. Department of Neuroradiology, UMass Memorial Hospital, Worcester, MA, USA. Department of Neuroradiology, Ospedale Niguarda Cà Granda, Milano, Italy. Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA. Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria. Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria. Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA. Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA. Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA. Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA. Department of Neuroradiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia. Department of Neuroradiology, Clínica La Sagrada Familia, Buenos Aires, Argentina. Department of Neuroradiology, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland. Department of Radiology, Medical Faculty of Ankara University, Ankara, Turkey. Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Department of Neuroradiology, Hôpital Pitié-Salpêtrière, Paris, France. Department of Neurosurgery and Neuroradiology, New York Presbyterian Hospital and Weill Cornell School of Medicine, New York, NY, USA. Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA. Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA. |
Issue Date: | 18-Jan-2024 | Date: | 2024 | Publication information: | Journal of Neurointerventional Surgery 2024-01-18 | Abstract: | The Woven EndoBridge (WEB) device is frequently used for the treatment of intracranial aneurysms. Postoperative management, including the use of aspirin, varies among clinicians and institutions, but its impact on the outcomes of the WEB has not been thoroughly investigated. This was a retrospective, multicenter study involving 30 academic institutions in North America, South America, and Europe. Data from 1492 patients treated with the WEB device were included. Patients were categorized into two groups based on their postoperative use of aspirin (aspirin group: n=1124, non-aspirin group: n=368). Data points included patient demographics, aneurysm characteristics, procedural details, complications, and angiographic and functional outcomes. Propensity score matching (PSM) was applied to balance variables between the two groups. Prior to PSM, the aspirin group exhibited significantly higher rates of modified Rankin scale (mRS) mRS 0-1 and mRS 0-2 (89.8% vs 73.4% and 94.1% vs 79.8%, p<0.001), lower rates of mortality (1.6% vs 8.6%, p<0.001), and higher major compaction rates (13.4% vs 7%, p<0.001). Post-PSM, the aspirin group showed significantly higher rates of retreatment (p=0.026) and major compaction (p=0.037) while maintaining its higher rates of good functional outcomes and lower mortality rates. In the multivariable regression, aspirin was associated with higher rates of mRS 0-1 (OR 2.166; 95% CI 1.16 to 4, p=0.016) and mRS 0-2 (OR 2.817; 95% CI 1.36 to 5.88, p=0.005) and lower rates of mortality (OR 0.228; 95% CI 0.06 to 0.83, p=0.025). However, it was associated with higher rates of retreatment (OR 2.471; 95% CI 1.11 to 5.51, p=0.027). Aspirin use post-WEB treatment may lead to better functional outcomes and lower mortality but with higher retreatment rates. These insights are crucial for postoperative management after WEB procedures, but further studies are necessary for validation. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/34960 | DOI: | 10.1136/jnis-2023-021082 | ORCID: | 0009-0000-4910-6090 0000-0002-8703-4304 0000-0001-5629-3023 0000-0003-4105-0664 0000-0001-7281-1652 0000-0002-9477-9996 0000-0003-3832-7976 0000-0001-5294-1003 0000-0002-8712-8431 0000-0003-0671-4111 0000-0001-8483-2995 0000-0002-6048-4225 0000-0002-2446-4315 0000-0001-8163-4600 0000-0001-8631-4227 0000-0001-6599-0269 0000-0002-1331-2551 0000-0003-0519-8936 0000-0001-6518-6828 0000-0003-1743-8781 0000-0001-6339-448X 0000-0003-2433-8404 0000-0002-7148-7616 0000-0001-8226-762X 0000-0002-9343-8276 0000-0002-2682-9736 0000-0001-5271-5524 0000-0001-7423-9725 0000-0001-8450-2021 0000-0002-6722-8267 0000-0001-8325-2382 0000-0002-2695-0042 0000-0002-8932-6909 0000-0003-2750-421X 0000-0003-2998-8481 0000-0001-5572-7694 0000-0002-9519-0059 0000-0003-3251-1086 0000-0003-4805-0093 0000-0001-6649-4128 0000-0002-1439-0930 0000-0002-1054-9414 0000-0002-8348-4535 0000-0002-1544-4910 |
Journal: | Journal of Neurointerventional Surgery | PubMed URL: | 38238006 | ISSN: | 1759-8486 | Type: | Journal Article | Subjects: | Aneurysm |
| Appears in Collections: | Journal articles |
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