Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment: Insights from the WorldWideWEB Consortium registry

Guillaume Saliou; Hamza Adel Salim; Basel Musmar; Nimer Adeeb; Assala Aslan; Christian Swaid; Miguel Cuellar; Mahmoud Dibas; Nicole M. Cancelliere; Jose Danilo Bengzon Diestro; Oktay Algin; Sherief Ghozy; Sovann V. Lay; Adrien Guenego; Leonardo Renieri; Joseph Anthony Carnevale; Panagiotis Mastorakos; Kareem Elnaamani; Eimad Shotar; Markus A. Möhlenbruch; Michael Kral; Charlotte Chung; Mohamed M. Salem; Ivan Lylyk; Paul M. Foreman; Hamza Shaikh; Vedran Župančić; Muhammad Ubaid Hafeez; Joshua S. Catapano; Muhammad Waqas; Muhammet Arslan; Onur Ergun; James D. Rabinov; Yifan Ren; Clemens M. Schirmer; Mariangela Piano; Anna Luisa Kuhn; Caterina Michelozzi; Robert M. Starke; Ameer E. Hassan; Mark Ogilvie; Anh Nguyen; Jesse Jones; Waleed Brinjikji; Marie Teresa Nawka; Marios Nikos Psychogios; Christian Ulfert; Bryan Pukenas; Jan Karl Burkhardt; Thien J. Huynh; Juan Carlos Martinez-Gutierrez; Muhammed Amir Essibayi; Sunil A. Sheth; Diana Slawski; Rabih Tawk; Benjamin Pulli; Boris Lubicz; Pietro Panni; Ajit S. Puri; Guglielmo Pero; Eytan Raz; Christoph J. Griessenauer; Hamed Asadi; Adnan H. Siddiqui; Elad I. Levy; Neil Haranhalli; David Altschul; Andrew F. Ducruet; Felipe C. Albuquerque; Robert W. Regenhardt; Christopher J. Stapleton; Peter Kan; Vladimir Kalousek; Pedro Lylyk; Srikanth Reddy Boddu; Jared Knopman; Stavropoula I. Tjoumakaris; Hugo Cuellar; Pascal Jabbour; Frédéric Clarençon; Nicola Limbucci; Vitor M. Pereira; Aman B. Patel; Adam A. Dmytriw; Steven D. Hajdu

doi:10.1136/jnis-2024-022628

Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment: Insights from the WorldWideWEB Consortium registry

Guillaume Saliou, Hamza Adel Salim, Basel Musmar, Nimer Adeeb, Assala Aslan, Christian Swaid, Miguel Cuellar, Mahmoud Dibas, Nicole M. Cancelliere, Jose Danilo Bengzon Diestro, Oktay Algin, Sherief Ghozy, Sovann V. Lay, Adrien Guenego, Leonardo Renieri, Joseph Anthony Carnevale, Panagiotis Mastorakos, Kareem Elnaamani, Eimad Shotar, Markus A. MöhlenbruchMichael Kral, Charlotte Chung, Mohamed M. Salem, Ivan Lylyk, Paul M. Foreman, Hamza Shaikh, Vedran Župančić, Muhammad Ubaid Hafeez, Joshua S. Catapano, Muhammad Waqas, Muhammet Arslan, Onur Ergun, James D. Rabinov, Yifan Ren, Clemens M. Schirmer, Mariangela Piano, Anna Luisa Kuhn, Caterina Michelozzi, Robert M. Starke, Ameer E. Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marie Teresa Nawka, Marios Nikos Psychogios, Christian Ulfert, Bryan Pukenas, Jan Karl Burkhardt, Thien J. Huynh, Juan Carlos Martinez-Gutierrez, Muhammed Amir Essibayi, Sunil A. Sheth, Diana Slawski, Rabih Tawk, Benjamin Pulli, Boris Lubicz, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Eytan Raz, Christoph J. Griessenauer, Hamed Asadi, Adnan H. Siddiqui, Elad I. Levy, Neil Haranhalli, David Altschul, Andrew F. Ducruet, Felipe C. Albuquerque, Robert W. Regenhardt, Christopher J. Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Reddy Boddu, Jared Knopman, Stavropoula I. Tjoumakaris, Hugo Cuellar, Pascal Jabbour, Frédéric Clarençon, Nicola Limbucci, Vitor M. Pereira, Aman B. Patel, Adam A. Dmytriw, Steven D. Hajdu

Neurosurgery

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

Abstract

Background: The Woven EndoBridge (WEB) device is a prevalent treatment for intracranial aneurysms. While many studies have assessed the obliteration rate post-WEB embolization, few have focused on long-term outcomes in partially thrombosed aneurysms. Objective: To assess whether partially thrombosed aneurysms are at higher risk of recurrence or retreatment following WEB embolization compared with non-thrombosed aneurysms. Methods: We evaluated data from 22 academic institutions, focusing on previously untreated cerebral aneurysms treated with the WEB device. Logistic regression was utilized to analyze factors predicting long-term aneurysm obliteration and retreatment necessity. Results: Among 1303 patients, 26 presented with a partially thrombosed aneurysm. In the partially thrombosed group, the mean aneurysm maximal diameter was 10.7±4 mm with a neck ratio of 1.99±1.19 mm, larger than in the control group where the mean aneurysm maximal diameter was 6.81±2.37 mm with a neck ratio of 1.64±0.51 mm (P<0.001 for both maximal diameter and neck ratio). At the final follow-up, partially thrombosed aneurysms treated by the WEB device had a 38.5% retreatment rate, compared with 7.0% for non-thrombosed aneurysms (P<0.001). Among partially thrombosed aneurysms, the Raymond-Roy type IIIa/b occlusion rate was higher (38.5% vs 9.9%, P<0.001). On multivariate analysis, partially thrombosed aneurysms compared with non-thrombosed aneurysms had an increased rate of retreatment (OR 3.64, 95% CI 1.28 to 10.1). Conclusion: Partially thrombosed aneurysms are associated with a poorer occlusion rate and a higher rate of retreatment following WEB embolization. For partially thrombosed aneurysms, the WEB device appears suboptimal as a first-line treatment, and therefore alternative techniques should be prioritized.

Original language	English (US)
Article number	1-8
Journal	Journal of neurointerventional surgery
DOIs	https://doi.org/10.1136/jnis-2024-022628
State	Accepted/In press - 2025

Keywords

Aneurysm
Coil
Hemorrhage
Subarachnoid

ASJC Scopus subject areas

Surgery
Clinical Neurology

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10.1136/jnis-2024-022628

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Saliou, G., Salim, H. A., Musmar, B., Adeeb, N., Aslan, A., Swaid, C., Cuellar, M., Dibas, M., Cancelliere, N. M., Diestro, J. D. B., Algin, O., Ghozy, S., Lay, S. V., Guenego, A., Renieri, L., Carnevale, J. A., Mastorakos, P., Elnaamani, K., Shotar, E., ... Hajdu, S. D. (Accepted/In press). Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment: Insights from the WorldWideWEB Consortium registry. Journal of neurointerventional surgery, Article 1-8. https://doi.org/10.1136/jnis-2024-022628

Saliou, G, Salim, HA, Musmar, B, Adeeb, N, Aslan, A, Swaid, C, Cuellar, M, Dibas, M, Cancelliere, NM, Diestro, JDB, Algin, O, Ghozy, S, Lay, SV, Guenego, A, Renieri, L, Carnevale, JA, Mastorakos, P, Elnaamani, K, Shotar, E, Möhlenbruch, MA, Kral, M, Chung, C, Salem, MM, Lylyk, I, Foreman, PM, Shaikh, H, Župančić, V, Hafeez, MU, Catapano, JS, Waqas, M, Arslan, M, Ergun, O, Rabinov, JD, Ren, Y, Schirmer, CM, Piano, M, Kuhn, AL, Michelozzi, C, Starke, RM, Hassan, AE, Ogilvie, M, Nguyen, A, Jones, J, Brinjikji, W, Nawka, MT, Psychogios, MN, Ulfert, C, Pukenas, B, Burkhardt, JK, Huynh, TJ, Martinez-Gutierrez, JC, Essibayi, MA, Sheth, SA, Slawski, D, Tawk, R, Pulli, B, Lubicz, B, Panni, P, Puri, AS, Pero, G, Raz, E, Griessenauer, CJ, Asadi, H, Siddiqui, AH, Levy, EI, Haranhalli, N, Altschul, D, Ducruet, AF, Albuquerque, FC, Regenhardt, RW, Stapleton, CJ, Kan, P, Kalousek, V, Lylyk, P, Boddu, SR, Knopman, J, Tjoumakaris, SI, Cuellar, H, Jabbour, P, Clarençon, F, Limbucci, N, Pereira, VM, Patel, AB, Dmytriw, AA & Hajdu, SD 2025, 'Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment: Insights from the WorldWideWEB Consortium registry', Journal of neurointerventional surgery. https://doi.org/10.1136/jnis-2024-022628

@article{84d8142ae68e40d3b9021fb26ba31ba3,

title = "Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment: Insights from the WorldWideWEB Consortium registry",

abstract = "Background: The Woven EndoBridge (WEB) device is a prevalent treatment for intracranial aneurysms. While many studies have assessed the obliteration rate post-WEB embolization, few have focused on long-term outcomes in partially thrombosed aneurysms. Objective: To assess whether partially thrombosed aneurysms are at higher risk of recurrence or retreatment following WEB embolization compared with non-thrombosed aneurysms. Methods: We evaluated data from 22 academic institutions, focusing on previously untreated cerebral aneurysms treated with the WEB device. Logistic regression was utilized to analyze factors predicting long-term aneurysm obliteration and retreatment necessity. Results: Among 1303 patients, 26 presented with a partially thrombosed aneurysm. In the partially thrombosed group, the mean aneurysm maximal diameter was 10.7±4 mm with a neck ratio of 1.99±1.19 mm, larger than in the control group where the mean aneurysm maximal diameter was 6.81±2.37 mm with a neck ratio of 1.64±0.51 mm (P<0.001 for both maximal diameter and neck ratio). At the final follow-up, partially thrombosed aneurysms treated by the WEB device had a 38.5% retreatment rate, compared with 7.0% for non-thrombosed aneurysms (P<0.001). Among partially thrombosed aneurysms, the Raymond-Roy type IIIa/b occlusion rate was higher (38.5% vs 9.9%, P<0.001). On multivariate analysis, partially thrombosed aneurysms compared with non-thrombosed aneurysms had an increased rate of retreatment (OR 3.64, 95% CI 1.28 to 10.1). Conclusion: Partially thrombosed aneurysms are associated with a poorer occlusion rate and a higher rate of retreatment following WEB embolization. For partially thrombosed aneurysms, the WEB device appears suboptimal as a first-line treatment, and therefore alternative techniques should be prioritized.",

keywords = "Aneurysm, Coil, Hemorrhage, Subarachnoid",

author = "Guillaume Saliou and Salim, {Hamza Adel} and Basel Musmar and Nimer Adeeb and Assala Aslan and Christian Swaid and Miguel Cuellar and Mahmoud Dibas and Cancelliere, {Nicole M.} and Diestro, {Jose Danilo Bengzon} and Oktay Algin and Sherief Ghozy and Lay, {Sovann V.} and Adrien Guenego and Leonardo Renieri and Carnevale, {Joseph Anthony} and Panagiotis Mastorakos and Kareem Elnaamani and Eimad Shotar and M{\"o}hlenbruch, {Markus A.} and Michael Kral and Charlotte Chung and Salem, {Mohamed M.} and Ivan Lylyk and Foreman, {Paul M.} and Hamza Shaikh and Vedran {\v Z}upan{\v c}i{\'c} and Hafeez, {Muhammad Ubaid} and Catapano, {Joshua S.} and Muhammad Waqas and Muhammet Arslan and Onur Ergun and Rabinov, {James D.} and Yifan Ren and Schirmer, {Clemens M.} and Mariangela Piano and Kuhn, {Anna Luisa} and Caterina Michelozzi and Starke, {Robert M.} and Hassan, {Ameer E.} and Mark Ogilvie and Anh Nguyen and Jesse Jones and Waleed Brinjikji and Nawka, {Marie Teresa} and Psychogios, {Marios Nikos} and Christian Ulfert and Bryan Pukenas and Burkhardt, {Jan Karl} and Huynh, {Thien J.} and Martinez-Gutierrez, {Juan Carlos} and Essibayi, {Muhammed Amir} and Sheth, {Sunil A.} and Diana Slawski and Rabih Tawk and Benjamin Pulli and Boris Lubicz and Pietro Panni and Puri, {Ajit S.} and Guglielmo Pero and Eytan Raz and Griessenauer, {Christoph J.} and Hamed Asadi and Siddiqui, {Adnan H.} and Levy, {Elad I.} and Neil Haranhalli and David Altschul and Ducruet, {Andrew F.} and Albuquerque, {Felipe C.} and Regenhardt, {Robert W.} and Stapleton, {Christopher J.} and Peter Kan and Vladimir Kalousek and Pedro Lylyk and Boddu, {Srikanth Reddy} and Jared Knopman and Tjoumakaris, {Stavropoula I.} and Hugo Cuellar and Pascal Jabbour and Fr{\'e}d{\'e}ric Claren{\c c}on and Nicola Limbucci and Pereira, {Vitor M.} and Patel, {Aman B.} and Dmytriw, {Adam A.} and Hajdu, {Steven D.}",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.",

year = "2025",

doi = "10.1136/jnis-2024-022628",

language = "English (US)",

journal = "Journal of neurointerventional surgery",

issn = "1759-8478",

publisher = "BMJ Publishing Group",

}

TY - JOUR

T1 - Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment

T2 - Insights from the WorldWideWEB Consortium registry

AU - Saliou, Guillaume

AU - Salim, Hamza Adel

AU - Musmar, Basel

AU - Adeeb, Nimer

AU - Aslan, Assala

AU - Swaid, Christian

AU - Cuellar, Miguel

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 Anthony

AU - Mastorakos, Panagiotis

AU - Elnaamani, Kareem

AU - Shotar, Eimad

AU - Möhlenbruch, Markus A.

AU - Kral, Michael

AU - Chung, Charlotte

AU - Salem, Mohamed M.

AU - Lylyk, Ivan

AU - Foreman, Paul M.

AU - Shaikh, Hamza

AU - Župančić, Vedran

AU - Hafeez, Muhammad Ubaid

AU - Catapano, Joshua S.

AU - Waqas, Muhammad

AU - Arslan, Muhammet

AU - Ergun, Onur

AU - Rabinov, James D.

AU - Ren, Yifan

AU - Schirmer, Clemens M.

AU - Piano, Mariangela

AU - Kuhn, Anna Luisa

AU - Michelozzi, Caterina

AU - Starke, Robert M.

AU - Hassan, Ameer E.

AU - Ogilvie, Mark

AU - Nguyen, Anh

AU - Jones, Jesse

AU - Brinjikji, Waleed

AU - Nawka, Marie Teresa

AU - Psychogios, Marios Nikos

AU - Ulfert, Christian

AU - Pukenas, Bryan

AU - Burkhardt, Jan Karl

AU - Huynh, Thien J.

AU - Martinez-Gutierrez, Juan Carlos

AU - Essibayi, Muhammed Amir

AU - Sheth, Sunil A.

AU - Slawski, Diana

AU - Tawk, Rabih

AU - Pulli, Benjamin

AU - Lubicz, Boris

AU - Panni, Pietro

AU - Puri, Ajit S.

AU - Pero, Guglielmo

AU - Raz, Eytan

AU - Griessenauer, Christoph J.

AU - Asadi, Hamed

AU - Siddiqui, Adnan H.

AU - Levy, Elad I.

AU - Haranhalli, Neil

AU - Altschul, David

AU - Ducruet, Andrew F.

AU - Albuquerque, Felipe C.

AU - Regenhardt, Robert W.

AU - Stapleton, Christopher J.

AU - Kan, Peter

AU - Kalousek, Vladimir

AU - Lylyk, Pedro

AU - Boddu, Srikanth Reddy

AU - Knopman, Jared

AU - Tjoumakaris, Stavropoula I.

AU - Cuellar, Hugo

AU - Jabbour, Pascal

AU - Clarençon, Frédéric

AU - Limbucci, Nicola

AU - Pereira, Vitor M.

AU - Patel, Aman B.

AU - Dmytriw, Adam A.

AU - Hajdu, Steven D.

PY - 2025

Y1 - 2025

N2 - Background: The Woven EndoBridge (WEB) device is a prevalent treatment for intracranial aneurysms. While many studies have assessed the obliteration rate post-WEB embolization, few have focused on long-term outcomes in partially thrombosed aneurysms. Objective: To assess whether partially thrombosed aneurysms are at higher risk of recurrence or retreatment following WEB embolization compared with non-thrombosed aneurysms. Methods: We evaluated data from 22 academic institutions, focusing on previously untreated cerebral aneurysms treated with the WEB device. Logistic regression was utilized to analyze factors predicting long-term aneurysm obliteration and retreatment necessity. Results: Among 1303 patients, 26 presented with a partially thrombosed aneurysm. In the partially thrombosed group, the mean aneurysm maximal diameter was 10.7±4 mm with a neck ratio of 1.99±1.19 mm, larger than in the control group where the mean aneurysm maximal diameter was 6.81±2.37 mm with a neck ratio of 1.64±0.51 mm (P<0.001 for both maximal diameter and neck ratio). At the final follow-up, partially thrombosed aneurysms treated by the WEB device had a 38.5% retreatment rate, compared with 7.0% for non-thrombosed aneurysms (P<0.001). Among partially thrombosed aneurysms, the Raymond-Roy type IIIa/b occlusion rate was higher (38.5% vs 9.9%, P<0.001). On multivariate analysis, partially thrombosed aneurysms compared with non-thrombosed aneurysms had an increased rate of retreatment (OR 3.64, 95% CI 1.28 to 10.1). Conclusion: Partially thrombosed aneurysms are associated with a poorer occlusion rate and a higher rate of retreatment following WEB embolization. For partially thrombosed aneurysms, the WEB device appears suboptimal as a first-line treatment, and therefore alternative techniques should be prioritized.

AB - Background: The Woven EndoBridge (WEB) device is a prevalent treatment for intracranial aneurysms. While many studies have assessed the obliteration rate post-WEB embolization, few have focused on long-term outcomes in partially thrombosed aneurysms. Objective: To assess whether partially thrombosed aneurysms are at higher risk of recurrence or retreatment following WEB embolization compared with non-thrombosed aneurysms. Methods: We evaluated data from 22 academic institutions, focusing on previously untreated cerebral aneurysms treated with the WEB device. Logistic regression was utilized to analyze factors predicting long-term aneurysm obliteration and retreatment necessity. Results: Among 1303 patients, 26 presented with a partially thrombosed aneurysm. In the partially thrombosed group, the mean aneurysm maximal diameter was 10.7±4 mm with a neck ratio of 1.99±1.19 mm, larger than in the control group where the mean aneurysm maximal diameter was 6.81±2.37 mm with a neck ratio of 1.64±0.51 mm (P<0.001 for both maximal diameter and neck ratio). At the final follow-up, partially thrombosed aneurysms treated by the WEB device had a 38.5% retreatment rate, compared with 7.0% for non-thrombosed aneurysms (P<0.001). Among partially thrombosed aneurysms, the Raymond-Roy type IIIa/b occlusion rate was higher (38.5% vs 9.9%, P<0.001). On multivariate analysis, partially thrombosed aneurysms compared with non-thrombosed aneurysms had an increased rate of retreatment (OR 3.64, 95% CI 1.28 to 10.1). Conclusion: Partially thrombosed aneurysms are associated with a poorer occlusion rate and a higher rate of retreatment following WEB embolization. For partially thrombosed aneurysms, the WEB device appears suboptimal as a first-line treatment, and therefore alternative techniques should be prioritized.

KW - Aneurysm

KW - Coil

KW - Hemorrhage

KW - Subarachnoid

UR - http://www.scopus.com/inward/record.url?scp=105004662080&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=105004662080&partnerID=8YFLogxK

U2 - 10.1136/jnis-2024-022628

DO - 10.1136/jnis-2024-022628

M3 - Article

C2 - 40306928

AN - SCOPUS:105004662080

SN - 1759-8478

JO - Journal of neurointerventional surgery

JF - Journal of neurointerventional surgery

M1 - 1-8

ER -

Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment: Insights from the WorldWideWEB Consortium registry

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Keywords

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