Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study

Dhrumil Vaishnav; Muhammed Amir Essibayi; Basel Musmar; Nimer Adeeb; Hamza Adel Salim; Assala Aslan; Nicole M Cancelliere; Rachel M McLellan; Oktay Algin; Sherief Ghozy; Sovann V Lay; Adrien Guenego; Leonardo Renieri; Joseph Carnevale; Guillaume Saliou; Panagiotis Mastorakos; Kareem El Naamani; Eimad Shotar; Kevin Premat; Markus Möhlenbruch; Michael Kral; Omer Doron; Charlotte Chung; Mohamed M Salem; Ivan Lylyk; Paul M Foreman; Jay A Vachhani; Hamza Shaikh; Vedran Župančić; Muhammad U Hafeez; Joshua Catapano; Muhammad Waqas; Giyas Ayberk; Yasin Celal Gunes; James D Rabinov; Yifan Ren; Clemens M Schirmer; Mariangela Piano; Anna L Kühn; Caterina Michelozzi; Stéphanie Elens; Robert M Starke; Ameer E Hassan; Mark Ogilvie; Anh Nguyen; Jesse Jones; Waleed Brinjikji; Marie T Nawka; Monika Killer-Oberpfalzer; Christoph J Griessenauer; WorldWideWEB Consortium

doi:10.3171/2024.10.JNS241058

Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study

Dhrumil Vaishnav
, Muhammed Amir Essibayi
, Basel Musmar
, Nimer Adeeb
, Hamza Adel Salim
, Assala Aslan
, Nicole M Cancelliere
, Rachel M McLellan
, Oktay Algin
, Sherief Ghozy
, Sovann V Lay
, Adrien Guenego
, Leonardo Renieri
, Joseph Carnevale
, Guillaume Saliou
, Panagiotis Mastorakos
, Kareem El Naamani
, Eimad Shotar
, Kevin Premat
, Markus Möhlenbruch

Michael Kral (Co-author), Omer Doron, Charlotte Chung, Mohamed M Salem, Ivan Lylyk, Paul M Foreman, Jay A Vachhani, Hamza Shaikh, Vedran Župančić, Muhammad U Hafeez, Joshua Catapano, Muhammad Waqas, Giyas Ayberk, Yasin Celal Gunes, James D Rabinov, Yifan Ren, Clemens M Schirmer (Co-author), Mariangela Piano, Anna L Kühn, Caterina Michelozzi, Stéphanie Elens, Robert M Starke, Ameer E Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marie T Nawka, Monika Killer-Oberpfalzer (Co-author), Christoph J Griessenauer (Co-author), WorldWideWEB Consortium

Albert Einstein College of Medicine
Louisiana State University System
St. Michael's Hospital
Massachusetts General Hospital & Brigham and Women's Hospital
Ankara University
Mayo Clinic Hospital
Kırıkkale Yüksek İhtisas Hospital
Centre Hospitalier de Toulouse
Hôpital Universitaire Erasme
Ospedale Careggi di Firenze
NewYork-Presbyterian Hospital and Weill Cornell School of Medicine
Centre Hospitalier Vaudois de Lausanne
Thomas Jefferson University Hospital
Hôpital Pitié-Salpêtrière
Christian Doppler University Hospital & Institute of Neurointervention
NYU Langone Health Center
University of Pennsylvania Medical Center
Clínica La Sagrada Familia
Orlando Health Neuroscience and Rehabilitation Institute
Cooper University Health Care
Clinical Hospital Center 'Sisters of Mercy'
UTMB and Baylor School of Medicine
Barrow Neurological Institute
State University of New York at Buffalo
Austin Health
Victoria University
Geisinger Hospital
UMass Memorial Hospital
IRCCS Ospedale San Raffaele
University of Miami
Valley Baptist Neuroscience Institute
University of Alabama at Birmingham
University Hospital Basel and University of Basel

Research output: Contribution to journal › Original Article › peer-review

Abstract

OBJECTIVE: Tobacco smoking is among the factors known to significantly augment the risk of untreated intracranial aneurysm (IA) growth and rupture. Smoking appears to have a variable effect on different endovascular treatment modalities. The impact of smoking on the safety, efficacy, and outcomes of Woven EndoBridge (WEB) device use for wide-neck IAs has not been evaluated. This study aimed to investigate the outcomes of WEB devices by smoking status.

METHODS: A retrospective multicenter analysis was conducted on the data of patients from 36 sites worldwide treated with the WEB device for intracranial saccular aneurysms. Patients were stratified based on smoking status (current, former, and never smokers). The Student t-test and chi-square test were performed for continuous and categorical variables, respectively. Multivariable logistic regression was used to adjust for confounders.

RESULTS: Of 1376 patients with available smoking status, 504 were current smokers, 358 were former smokers, and 514 were never smokers. Upon adjusting for significant confounders, no association was found between smoking and recurrence outcomes (OR 1.39, 95% CI 0.69-2.80; p = 0.36), thromboembolic and hemorrhagic complications, and mortality among IAs treated with the WEB device. There was no statistically significant difference in outcomes between former and never smokers (OR 1.23, 95% CI 0.70-2.18; p = 0.46). The location of aneurysms differed between smoking groups, with former smokers having more anterior circulation aneurysms compared with current and never smokers (99.0% vs 96.9% vs 95.3%; p = 0.01). In terms of clinical symptoms, headache and dizziness were more common in the never smokers compared with current and former smokers (13.9% vs 8.9% vs 7.7%, p = 0.01).

CONCLUSIONS: This large-scale study suggests no significant correlation between smoking and the recurrence of IAs treated with the WEB device. Biological studies are warranted to better understand the biological impact of smoking on the growth and rupture of treated IAs.

Original language	English
Pages (from-to)	1732-1740
Number of pages	9
Journal	Journal of Neurosurgery
Volume	142
Issue number	6
DOIs	https://doi.org/10.3171/2024.10.JNS241058
Publication status	Published - 1 Jun 2025

Keywords

Humans
Intracranial Aneurysm/surgery
Retrospective Studies
Male
Female
Middle Aged
Aged
Recurrence
Smoking/adverse effects
Endovascular Procedures/methods
Treatment Outcome
Adult

Access to Document

10.3171/2024.10.JNS241058

Cite this

Vaishnav, D., Essibayi, M. A., Musmar, B., Adeeb, N., Salim, H. A., Aslan, A., Cancelliere, N. M., McLellan, R. M., Algin, O., Ghozy, S., Lay, S. V., Guenego, A., Renieri, L., Carnevale, J., Saliou, G., Mastorakos, P., El Naamani, K., Shotar, E., Premat, K., ... WorldWideWEB Consortium (2025). Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study. Journal of Neurosurgery, 142(6), 1732-1740. https://doi.org/10.3171/2024.10.JNS241058

@article{c5603d547e37496dbde6b6169c453afb,

title = "Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study",

abstract = "OBJECTIVE: Tobacco smoking is among the factors known to significantly augment the risk of untreated intracranial aneurysm (IA) growth and rupture. Smoking appears to have a variable effect on different endovascular treatment modalities. The impact of smoking on the safety, efficacy, and outcomes of Woven EndoBridge (WEB) device use for wide-neck IAs has not been evaluated. This study aimed to investigate the outcomes of WEB devices by smoking status.METHODS: A retrospective multicenter analysis was conducted on the data of patients from 36 sites worldwide treated with the WEB device for intracranial saccular aneurysms. Patients were stratified based on smoking status (current, former, and never smokers). The Student t-test and chi-square test were performed for continuous and categorical variables, respectively. Multivariable logistic regression was used to adjust for confounders.RESULTS: Of 1376 patients with available smoking status, 504 were current smokers, 358 were former smokers, and 514 were never smokers. Upon adjusting for significant confounders, no association was found between smoking and recurrence outcomes (OR 1.39, 95\% CI 0.69-2.80; p = 0.36), thromboembolic and hemorrhagic complications, and mortality among IAs treated with the WEB device. There was no statistically significant difference in outcomes between former and never smokers (OR 1.23, 95\% CI 0.70-2.18; p = 0.46). The location of aneurysms differed between smoking groups, with former smokers having more anterior circulation aneurysms compared with current and never smokers (99.0\% vs 96.9\% vs 95.3\%; p = 0.01). In terms of clinical symptoms, headache and dizziness were more common in the never smokers compared with current and former smokers (13.9\% vs 8.9\% vs 7.7\%, p = 0.01).CONCLUSIONS: This large-scale study suggests no significant correlation between smoking and the recurrence of IAs treated with the WEB device. Biological studies are warranted to better understand the biological impact of smoking on the growth and rupture of treated IAs.",

keywords = "Humans, Intracranial Aneurysm/surgery, Retrospective Studies, Male, Female, Middle Aged, Aged, Recurrence, Smoking/adverse effects, Endovascular Procedures/methods, Treatment Outcome, Adult",

author = "Dhrumil Vaishnav and Essibayi, \{Muhammed Amir\} and Basel Musmar and Nimer Adeeb and Salim, \{Hamza Adel\} and Assala Aslan and Cancelliere, \{Nicole M\} and McLellan, \{Rachel M\} and Oktay Algin and Sherief Ghozy and Lay, \{Sovann V\} and Adrien Guenego and Leonardo Renieri and Joseph Carnevale and Guillaume Saliou and Panagiotis Mastorakos and \{El Naamani\}, Kareem and Eimad Shotar and Kevin Premat and Markus M{\"o}hlenbruch and Michael Kral and Omer Doron and Charlotte Chung and Salem, \{Mohamed M\} and Ivan Lylyk and Foreman, \{Paul M\} and Vachhani, \{Jay A\} and Hamza Shaikh and Vedran {\v Z}upan{\v c}i{\'c} and Hafeez, \{Muhammad U\} and Joshua Catapano and Muhammad Waqas and Giyas Ayberk and \{Celal Gunes\}, Yasin and Rabinov, \{James D\} and Yifan Ren and Schirmer, \{Clemens M\} and Mariangela Piano and K{\"u}hn, \{Anna L\} and Caterina Michelozzi and St{\'e}phanie Elens and Starke, \{Robert M\} and Hassan, \{Ameer E\} and Mark Ogilvie and Anh Nguyen and Jesse Jones and Waleed Brinjikji and Nawka, \{Marie T\} and Monika Killer-Oberpfalzer and Griessenauer, \{Christoph J\} and \{WorldWideWEB Consortium\}",

note = "die Affiliation wurden falsch indexed; korrekt ist die Affilation 16 und nicht 15 (Heidelberg) Killer, Griessenauer: Department of Neurosurgery, Christian Doppler University Hospital \& Institute of Neurointervention, Salzburg, Austria (PMU leider nicht genannt); Schirmer: externe Aff.; CGriessenauer hat eine Korrektur beim Journal am 17.02.2026 eingreicht; daher wurde die PMU genannt auf ja gesetzt. ",

year = "2025",

month = jun,

day = "1",

doi = "10.3171/2024.10.JNS241058",

language = "English",

volume = "142",

pages = "1732--1740",

journal = "Journal of Neurosurgery",

issn = "0022-3085",

publisher = "Amer Assoc Neurological Surgeons",

number = "6",

}

Vaishnav, D, Essibayi, MA, Musmar, B, Adeeb, N, Salim, HA, Aslan, A, Cancelliere, NM, McLellan, RM, Algin, O, Ghozy, S, Lay, SV, Guenego, A, Renieri, L, Carnevale, J, Saliou, G, Mastorakos, P, El Naamani, K, Shotar, E, Premat, K, Möhlenbruch, M, Kral, M, Doron, O, Chung, C, Salem, MM, Lylyk, I, Foreman, PM, Vachhani, JA, Shaikh, H, Župančić, V, Hafeez, MU, Catapano, J, Waqas, M, Ayberk, G, Celal Gunes, Y, Rabinov, JD, Ren, Y, Schirmer, CM, Piano, M, Kühn, AL, Michelozzi, C, Elens, S, Starke, RM, Hassan, AE, Ogilvie, M, Nguyen, A, Jones, J, Brinjikji, W, Nawka, MT, Killer-Oberpfalzer, M , Griessenauer, CJ & WorldWideWEB Consortium 2025, 'Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study', Journal of Neurosurgery, vol. 142, no. 6, pp. 1732-1740. https://doi.org/10.3171/2024.10.JNS241058

TY - JOUR

T1 - Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge

T2 - a multicenter retrospective study

AU - Vaishnav, Dhrumil

AU - Essibayi, Muhammed Amir

AU - Musmar, Basel

AU - Adeeb, Nimer

AU - Salim, Hamza Adel

AU - Aslan, Assala

AU - Cancelliere, Nicole M

AU - McLellan, Rachel M

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 - El Naamani, Kareem

AU - Shotar, Eimad

AU - Premat, Kevin

AU - Möhlenbruch, Markus

AU - Kral, Michael

AU - Doron, Omer

AU - Chung, Charlotte

AU - Salem, Mohamed M

AU - Lylyk, Ivan

AU - Foreman, Paul M

AU - Vachhani, Jay A

AU - Shaikh, Hamza

AU - Župančić, Vedran

AU - Hafeez, Muhammad U

AU - Catapano, Joshua

AU - Waqas, Muhammad

AU - Ayberk, Giyas

AU - Celal Gunes, Yasin

AU - Rabinov, James D

AU - Ren, Yifan

AU - Schirmer, Clemens M

AU - Piano, Mariangela

AU - Kühn, Anna L

AU - Michelozzi, Caterina

AU - Elens, Stéphanie

AU - Starke, Robert M

AU - Hassan, Ameer E

AU - Ogilvie, Mark

AU - Nguyen, Anh

AU - Jones, Jesse

AU - Brinjikji, Waleed

AU - Nawka, Marie T

AU - Killer-Oberpfalzer, Monika

AU - Griessenauer, Christoph J

AU - WorldWideWEB Consortium

N1 - die Affiliation wurden falsch indexed; korrekt ist die Affilation 16 und nicht 15 (Heidelberg) Killer, Griessenauer: Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria (PMU leider nicht genannt); Schirmer: externe Aff.; CGriessenauer hat eine Korrektur beim Journal am 17.02.2026 eingreicht; daher wurde die PMU genannt auf ja gesetzt.

PY - 2025/6/1

Y1 - 2025/6/1

N2 - OBJECTIVE: Tobacco smoking is among the factors known to significantly augment the risk of untreated intracranial aneurysm (IA) growth and rupture. Smoking appears to have a variable effect on different endovascular treatment modalities. The impact of smoking on the safety, efficacy, and outcomes of Woven EndoBridge (WEB) device use for wide-neck IAs has not been evaluated. This study aimed to investigate the outcomes of WEB devices by smoking status.METHODS: A retrospective multicenter analysis was conducted on the data of patients from 36 sites worldwide treated with the WEB device for intracranial saccular aneurysms. Patients were stratified based on smoking status (current, former, and never smokers). The Student t-test and chi-square test were performed for continuous and categorical variables, respectively. Multivariable logistic regression was used to adjust for confounders.RESULTS: Of 1376 patients with available smoking status, 504 were current smokers, 358 were former smokers, and 514 were never smokers. Upon adjusting for significant confounders, no association was found between smoking and recurrence outcomes (OR 1.39, 95% CI 0.69-2.80; p = 0.36), thromboembolic and hemorrhagic complications, and mortality among IAs treated with the WEB device. There was no statistically significant difference in outcomes between former and never smokers (OR 1.23, 95% CI 0.70-2.18; p = 0.46). The location of aneurysms differed between smoking groups, with former smokers having more anterior circulation aneurysms compared with current and never smokers (99.0% vs 96.9% vs 95.3%; p = 0.01). In terms of clinical symptoms, headache and dizziness were more common in the never smokers compared with current and former smokers (13.9% vs 8.9% vs 7.7%, p = 0.01).CONCLUSIONS: This large-scale study suggests no significant correlation between smoking and the recurrence of IAs treated with the WEB device. Biological studies are warranted to better understand the biological impact of smoking on the growth and rupture of treated IAs.

AB - OBJECTIVE: Tobacco smoking is among the factors known to significantly augment the risk of untreated intracranial aneurysm (IA) growth and rupture. Smoking appears to have a variable effect on different endovascular treatment modalities. The impact of smoking on the safety, efficacy, and outcomes of Woven EndoBridge (WEB) device use for wide-neck IAs has not been evaluated. This study aimed to investigate the outcomes of WEB devices by smoking status.METHODS: A retrospective multicenter analysis was conducted on the data of patients from 36 sites worldwide treated with the WEB device for intracranial saccular aneurysms. Patients were stratified based on smoking status (current, former, and never smokers). The Student t-test and chi-square test were performed for continuous and categorical variables, respectively. Multivariable logistic regression was used to adjust for confounders.RESULTS: Of 1376 patients with available smoking status, 504 were current smokers, 358 were former smokers, and 514 were never smokers. Upon adjusting for significant confounders, no association was found between smoking and recurrence outcomes (OR 1.39, 95% CI 0.69-2.80; p = 0.36), thromboembolic and hemorrhagic complications, and mortality among IAs treated with the WEB device. There was no statistically significant difference in outcomes between former and never smokers (OR 1.23, 95% CI 0.70-2.18; p = 0.46). The location of aneurysms differed between smoking groups, with former smokers having more anterior circulation aneurysms compared with current and never smokers (99.0% vs 96.9% vs 95.3%; p = 0.01). In terms of clinical symptoms, headache and dizziness were more common in the never smokers compared with current and former smokers (13.9% vs 8.9% vs 7.7%, p = 0.01).CONCLUSIONS: This large-scale study suggests no significant correlation between smoking and the recurrence of IAs treated with the WEB device. Biological studies are warranted to better understand the biological impact of smoking on the growth and rupture of treated IAs.

KW - Humans

KW - Intracranial Aneurysm/surgery

KW - Retrospective Studies

KW - Male

KW - Female

KW - Middle Aged

KW - Aged

KW - Recurrence

KW - Smoking/adverse effects

KW - Endovascular Procedures/methods

KW - Treatment Outcome

KW - Adult

U2 - 10.3171/2024.10.JNS241058

DO - 10.3171/2024.10.JNS241058

M3 - Original Article

C2 - 39889291

SN - 0022-3085

VL - 142

SP - 1732

EP - 1740

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

IS - 6

ER -

Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study

Abstract

Keywords

Access to Document

Fingerprint

Cite this