TY - JOUR
T1 - Factors influencing immediate post-angiographic occlusion outcomes in intracranial aneurysms treated with the woven endobridge device
T2 - a multi-center analysis and predictive model from the WorldWideWEB consortium
AU - Essibayi, Muhammed Amir
AU - Jabal, Mohamed Sobhi
AU - Jamil, Hasan
AU - Salim, Hamza Adel
AU - Musmar, Basel
AU - Adeeb, Nimer
AU - Dibas, Mahmoud
AU - Cancelliere, Nicole M.
AU - Diestro, Jose Danilo Bengzon
AU - Algin, Oktay
AU - Ghozy, Sherief
AU - Lay, Sovann V.
AU - Guenego, Adrien
AU - Renieri, Leonardo
AU - Carnevale, Joseph
AU - Saliou, Guillaume
AU - Mastorakos, Panagiotis
AU - Naamani, Kareem El
AU - Momin, Arbaz A.
AU - Shotar, Eimad
AU - Mohlenbruch, Markus
AU - Kral, Michael
AU - Chung, Charlotte
AU - Salem, Mohamed M.
AU - Lylyk, Ivan
AU - Foreman, Paul M.
AU - Shaikh, Hamza
AU - Zupancic, Vedran
AU - Hafeez, Muhammad U.
AU - Catapano, Joshua
AU - Waqas, Muhammad
AU - Besler, Muhammed Said
AU - Gunes, Yasin Celal
AU - Rabinov, James D.
AU - Maingard, Julian
AU - Schirmer, Clemens M.
AU - Piano, Mariangela
AU - Kuhn, Anna L.
AU - Michelozzi, Caterina
AU - Starke, Robert M.
AU - Hassan, Ameer
AU - Ogilvie, Mark
AU - Nguyen, Anh
AU - Jones, Jesse
AU - Brinjikji, Waleed
AU - Nawka, Marie T.
AU - Psychogios, Marios
AU - Ulfert, Christian
AU - Pukenas, Bryan
AU - Griessenauer, Christoph J.
AU - WorldWideWEB Consortium Collaborators
A2 - Killer-Oberpfalzer, Monika
N1 - Kral, Griessenauer: Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria;
study group member: Killer-Oberpfalzer
PY - 2025/12/2
Y1 - 2025/12/2
N2 - The Woven EndoBridge (WEB) device treats wide-necked bifurcation aneurysms, but occlusion rates vary. This study aims to identify factors associated with immediate WEB device occlusion. Data from patients treated with WEB devices across 36 sites were analyzed. Machine learning algorithms and ordinal regression models were developed to predict immediate incomplete occlusion for ruptured and unruptured aneurysms. The study included 1565 patients, with 436 ruptured and 1129 unruptured aneurysms. Immediate complete occlusion was achieved in 38.3% of ruptured and 32.8% of unruptured aneurysms. For ruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.69. Key predictors of incomplete occlusion included pretreatment mRS, aneurysm diameter, and MCA location. Ordinal regression revealed that smoking history (OR: 1.95, p < 0.001), neck diameter (Odds Ratio [OR]: 1.50, p < 0.001), and presence of a branch from the aneurysm (OR: 2.06, p = 0.016) were associated with incomplete, while bifurcation aneurysms (OR: 0.55, p = 0.017) were associated with complete immediate occlusion. For unruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.68. Significant predictors of immediate incomplete occlusion included aneurysm neck width, MCA location, and presence of daughter sac. Ordinal regression revealed that smoking history (OR: 1.29, p = 0.032), neck diameter (OR: 1.24, p < 0.001), and presence of a daughter sac (OR: 1.53, p = 0.005) were associated with incomplete, while bifurcation aneurysms (OR: 0.71, p = 0.02) and posterior circulation location (OR: 0.68, p = 0.01) were associated with complete immediate occlusion. Careful evaluation of patient demographics and specific aneurysm characteristics may help improve the outcomes of intracranial aneurysms treated with WEB device.
AB - The Woven EndoBridge (WEB) device treats wide-necked bifurcation aneurysms, but occlusion rates vary. This study aims to identify factors associated with immediate WEB device occlusion. Data from patients treated with WEB devices across 36 sites were analyzed. Machine learning algorithms and ordinal regression models were developed to predict immediate incomplete occlusion for ruptured and unruptured aneurysms. The study included 1565 patients, with 436 ruptured and 1129 unruptured aneurysms. Immediate complete occlusion was achieved in 38.3% of ruptured and 32.8% of unruptured aneurysms. For ruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.69. Key predictors of incomplete occlusion included pretreatment mRS, aneurysm diameter, and MCA location. Ordinal regression revealed that smoking history (OR: 1.95, p < 0.001), neck diameter (Odds Ratio [OR]: 1.50, p < 0.001), and presence of a branch from the aneurysm (OR: 2.06, p = 0.016) were associated with incomplete, while bifurcation aneurysms (OR: 0.55, p = 0.017) were associated with complete immediate occlusion. For unruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.68. Significant predictors of immediate incomplete occlusion included aneurysm neck width, MCA location, and presence of daughter sac. Ordinal regression revealed that smoking history (OR: 1.29, p = 0.032), neck diameter (OR: 1.24, p < 0.001), and presence of a daughter sac (OR: 1.53, p = 0.005) were associated with incomplete, while bifurcation aneurysms (OR: 0.71, p = 0.02) and posterior circulation location (OR: 0.68, p = 0.01) were associated with complete immediate occlusion. Careful evaluation of patient demographics and specific aneurysm characteristics may help improve the outcomes of intracranial aneurysms treated with WEB device.
KW - Aneurysms
KW - Brain
KW - Immediate occlusion
KW - Woven EndoBridge
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001629051200001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1007/s10143-025-03928-w
DO - 10.1007/s10143-025-03928-w
M3 - Original Article
C2 - 41326865
SN - 0344-5607
VL - 49
JO - NEUROSURGICAL REVIEW
JF - NEUROSURGICAL REVIEW
IS - 1
M1 - 36
ER -