Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of aMulticenter Retrospective Study

Panagiotis Mastorakos; Kareem El Naamani; Nimer Adeeb; Mathews Lan; James Castiglione; Omaditya Khanna; Ritam Ghosh; Jose Danilo Bengzon Diestro; Mahmoud Dibas; Rachel M. McLellan; Oktay Algin; Sherief Ghozy; Nicole M. Cancelliere; Assala Aslan; Hugo H. Cuellar-Saenz; Sovann V. Lay; Adrien Guenego; Leonardo Renieri; Joseph Carnevale; Guillaume Saliou; Eimad Shotar; Kevin Premat; Markus Möhlenbruch; Michael Kral; Justin E. Vranic; Charlotte Chung; Mohamed M. Salem; Ivan Lylyk; Paul M. Foreman; Jay A. Vachhani; Hamza Shaikh; Vedran Župančić; Muhammad U. Hafeez; Joshua Catapano; Muhammad Waqas; Vincent M. Tutino; Mohamed K. Ibrahim; Marwa A. Mohammed; James D. Rabinov; Yifan Ren; Clemens M. Schirmer; Mariangela Piano; Maria Bres Bullrich; Michael Mayich; Anna L. Kühn; Caterina Michelozzi; Stéphanie Elens; Robert M. Starke; Ameer E. Hassan; Mark Ogilvie; Anh Nguyen; Jesse Jones; Waleed Brinjikji; Marios Psychogios; Christian Ulfert; Julian Spears; Brian T. Jankowitz; Jan Karl Burkhardt; Ricardo A. Domingo; Thien Huynh; Rabih G. Tawk; Boris Lubicz; Marie T. Nawka; Pietro Panni; Ajit S. Puri; Guglielmo Pero; Erez Nossek; Eytan Raz; Monika Killer-Oberpfalze; M. Ozgur Ozates; Giyas Ayberk; Robert W. Regenhardt; Christoph J. Griessenauer; Hamed Asadi; Adnan Siddiqui; Andrew F. Ducruet; Felipe C. Albuquerque; Nirav J. Patel; Christopher J. Stapleton; Peter Kan; Vladimir Kalousek; Pedro Lylyk; Srikanth Boddu; Jared Knopman; Mohammad A. Aziz-Sultan; Frédéric Clarençon; Nicola Limbucci; Mario Zanaty; Juan Carlos Martinez-Gutierrez; Sunil Sheth; Gary Spiegel; Rawad Abbas; Abdelaziz Amllay; Stavropoula I. Tjoumakaris; Michael R. Gooch; Nabeel A. Herial; Robert H. Rosenwasser; Hekmat Zarzour; Richard F. Schmidt; Vitor Mendes Pereira; Aman B. Patel; Pascal M. Jabbour; Adam A. Dmytriw

doi:10.3174/ajnr.A8324

Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of aMulticenter Retrospective Study

Panagiotis Mastorakos, Kareem El Naamani, Nimer Adeeb, Mathews Lan, James Castiglione, Omaditya Khanna, Ritam Ghosh, Jose Danilo Bengzon Diestro, Mahmoud Dibas, Rachel M. McLellan, Oktay Algin, Sherief Ghozy, Nicole M. Cancelliere, Assala Aslan, Hugo H. Cuellar-Saenz, Sovann V. Lay, Adrien Guenego, Leonardo Renieri, Joseph Carnevale, Guillaume SaliouEimad Shotar, Kevin Premat, Markus Möhlenbruch, Michael Kral, Justin E. Vranic, Charlotte Chung, Mohamed M. Salem, Ivan Lylyk, Paul M. Foreman, Jay A. Vachhani, Hamza Shaikh, Vedran Župančić, Muhammad U. Hafeez, Joshua Catapano, Muhammad Waqas, Vincent M. Tutino, Mohamed K. Ibrahim, Marwa A. Mohammed, James D. Rabinov, Yifan Ren, Clemens M. Schirmer, Mariangela Piano, Maria Bres Bullrich, Michael Mayich, Anna L. Kühn, Caterina Michelozzi, Stéphanie Elens, Robert M. Starke, Ameer E. Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marios Psychogios, Christian Ulfert, Julian Spears, Brian T. Jankowitz, Jan Karl Burkhardt, Ricardo A. Domingo, Thien Huynh, Rabih G. Tawk, Boris Lubicz, Marie T. Nawka, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Erez Nossek, Eytan Raz, Monika Killer-Oberpfalze, M. Ozgur Ozates, Giyas Ayberk, Robert W. Regenhardt, Christoph J. Griessenauer, Hamed Asadi, Adnan Siddiqui, Andrew F. Ducruet, Felipe C. Albuquerque, Nirav J. Patel, Christopher J. Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Jared Knopman, Mohammad A. Aziz-Sultan, Frédéric Clarençon, Nicola Limbucci, Mario Zanaty, Juan Carlos Martinez-Gutierrez, Sunil Sheth, Gary Spiegel, Rawad Abbas, Abdelaziz Amllay, Stavropoula I. Tjoumakaris, Michael R. Gooch, Nabeel A. Herial, Robert H. Rosenwasser, Hekmat Zarzour, Richard F. Schmidt, Vitor Mendes Pereira, Aman B. Patel, Pascal M. Jabbour, Adam A. Dmytriw

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

Abstract

BACKGROUND AND PURPOSE: Despite the numerous studies evaluating the occlusion rates of aneurysms following WEB embolization, there are limited studies identifying predictors of occlusion. Our purpose was to identify predictors of aneurysm occlusion and the need for retreatment. MATERIALS AND METHODS: This is a review of a prospectively maintained database across 30 academic institutions. We included patients with previously untreated cerebral aneurysms embolized using the WEB who had available intraprocedural data and longterm follow-up. RESULTS: We studied 763 patients with a mean age of 59.9 (SD, 11.7) years. Complete aneurysm occlusion was observed in 212/726 (29.2%) cases, and contrast stasis was observed in 485/537 (90.3%) of nonoccluded aneurysms. At the final follow-up, complete occlusion was achieved in 497/763 (65.1%) patients, and retreatment was required for 56/763 (7.3%) patients. On multivariable analysis, history of smoking, maximal aneurysm diameter, and the presence of an aneurysm wall branch were negative predictors of complete occlusion (OR, 0.5, 0.8, and 0.4, respectively). Maximal aneurysm diameter, the presence of an aneurysm wall branch, posterior circulation location, and male sex increase the chances of retreatment (OR, 1.2, 3.8, 3.0, and 2.3 respectively). Intraprocedural occlusion resulted in a 3-fold increase in the long-term occlusion rate and a 5-fold decrease in the retreatment rate (P < .001), offering a specificity of 87% and a positive predictive value of 85% for long-term occlusion. CONCLUSIONS: Intraprocedural occlusion can be used to predict the chance of long-term aneurysm occlusion and the need for retreatment after embolization with a WEB device. Smoking, aneurysm size, and the presence of an aneurysm wall branch are associated with decreased chances of successful treatment.

Original language	English (US)
Pages (from-to)	906-911
Number of pages	6
Journal	American Journal of Neuroradiology
Volume	45
Issue number	7
DOIs	https://doi.org/10.3174/ajnr.A8324
State	Published - Jul 1 2024
Externally published	Yes

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Clinical Neurology

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10.3174/ajnr.A8324

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Mastorakos, P., El Naamani, K., Adeeb, N., Lan, M., Castiglione, J., Khanna, O., Ghosh, R., Diestro, J. D. B., Dibas, M., McLellan, R. M., Algin, O., Ghozy, S., Cancelliere, N. M., Aslan, A., Cuellar-Saenz, H. H., Lay, S. V., Guenego, A., Renieri, L., Carnevale, J., ... Dmytriw, A. A. (2024). Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of aMulticenter Retrospective Study. American Journal of Neuroradiology, 45(7), 906-911. https://doi.org/10.3174/ajnr.A8324

Mastorakos, P, El Naamani, K, Adeeb, N, Lan, M, Castiglione, J, Khanna, O, Ghosh, R, Diestro, JDB, Dibas, M, McLellan, RM, Algin, O, Ghozy, S, Cancelliere, NM, Aslan, A, Cuellar-Saenz, HH, Lay, SV, Guenego, A, Renieri, L, Carnevale, J, Saliou, G, Shotar, E, Premat, K, Möhlenbruch, M, Kral, M, Vranic, JE, Chung, C, Salem, MM, Lylyk, I, Foreman, PM, Vachhani, JA, Shaikh, H, Župančić, V, Hafeez, MU, Catapano, J, Waqas, M, Tutino, VM, Ibrahim, MK, Mohammed, MA, Rabinov, JD, Ren, Y, Schirmer, CM, Piano, M, Bullrich, MB, Mayich, M, Kühn, AL, Michelozzi, C, Elens, S, Starke, RM, Hassan, AE, Ogilvie, M, Nguyen, A, Jones, J, Brinjikji, W, Psychogios, M, Ulfert, C, Spears, J, Jankowitz, BT, Burkhardt, JK, Domingo, RA, Huynh, T, Tawk, RG, Lubicz, B, Nawka, MT, Panni, P, Puri, AS, Pero, G, Nossek, E, Raz, E, Killer-Oberpfalze, M, Ozates, MO, Ayberk, G, Regenhardt, RW, Griessenauer, CJ, Asadi, H, Siddiqui, A, Ducruet, AF, Albuquerque, FC, Patel, NJ, Stapleton, CJ, Kan, P, Kalousek, V, Lylyk, P, Boddu, S, Knopman, J, Aziz-Sultan, MA, Clarençon, F, Limbucci, N, Zanaty, M, Martinez-Gutierrez, JC, Sheth, S, Spiegel, G, Abbas, R, Amllay, A, Tjoumakaris, SI, Gooch, MR, Herial, NA, Rosenwasser, RH, Zarzour, H, Schmidt, RF, Pereira, VM, Patel, AB, Jabbour, PM & Dmytriw, AA 2024, 'Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of aMulticenter Retrospective Study', American Journal of Neuroradiology, vol. 45, no. 7, pp. 906-911. https://doi.org/10.3174/ajnr.A8324

@article{ce402f85dcd44306a28d5e20571d29a0,

title = "Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of aMulticenter Retrospective Study",

abstract = "BACKGROUND AND PURPOSE: Despite the numerous studies evaluating the occlusion rates of aneurysms following WEB embolization, there are limited studies identifying predictors of occlusion. Our purpose was to identify predictors of aneurysm occlusion and the need for retreatment. MATERIALS AND METHODS: This is a review of a prospectively maintained database across 30 academic institutions. We included patients with previously untreated cerebral aneurysms embolized using the WEB who had available intraprocedural data and longterm follow-up. RESULTS: We studied 763 patients with a mean age of 59.9 (SD, 11.7) years. Complete aneurysm occlusion was observed in 212/726 (29.2%) cases, and contrast stasis was observed in 485/537 (90.3%) of nonoccluded aneurysms. At the final follow-up, complete occlusion was achieved in 497/763 (65.1%) patients, and retreatment was required for 56/763 (7.3%) patients. On multivariable analysis, history of smoking, maximal aneurysm diameter, and the presence of an aneurysm wall branch were negative predictors of complete occlusion (OR, 0.5, 0.8, and 0.4, respectively). Maximal aneurysm diameter, the presence of an aneurysm wall branch, posterior circulation location, and male sex increase the chances of retreatment (OR, 1.2, 3.8, 3.0, and 2.3 respectively). Intraprocedural occlusion resulted in a 3-fold increase in the long-term occlusion rate and a 5-fold decrease in the retreatment rate (P < .001), offering a specificity of 87% and a positive predictive value of 85% for long-term occlusion. CONCLUSIONS: Intraprocedural occlusion can be used to predict the chance of long-term aneurysm occlusion and the need for retreatment after embolization with a WEB device. Smoking, aneurysm size, and the presence of an aneurysm wall branch are associated with decreased chances of successful treatment.",

author = "Panagiotis Mastorakos and {El Naamani}, Kareem and Nimer Adeeb and Mathews Lan and James Castiglione and Omaditya Khanna and Ritam Ghosh and Diestro, {Jose Danilo Bengzon} and Mahmoud Dibas and McLellan, {Rachel M.} and Oktay Algin and Sherief Ghozy and Cancelliere, {Nicole M.} and Assala Aslan and Cuellar-Saenz, {Hugo H.} and Lay, {Sovann V.} and Adrien Guenego and Leonardo Renieri and Joseph Carnevale and Guillaume Saliou and Eimad Shotar and Kevin Premat and Markus M{\"o}hlenbruch and Michael Kral and Vranic, {Justin E.} 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 Tutino, {Vincent M.} and Ibrahim, {Mohamed K.} and Mohammed, {Marwa A.} and Rabinov, {James D.} and Yifan Ren and Schirmer, {Clemens M.} and Mariangela Piano and Bullrich, {Maria Bres} and Michael Mayich 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 Marios Psychogios and Christian Ulfert and Julian Spears and Jankowitz, {Brian T.} and Burkhardt, {Jan Karl} and Domingo, {Ricardo A.} and Thien Huynh and Tawk, {Rabih G.} and Boris Lubicz and Nawka, {Marie T.} and Pietro Panni and Puri, {Ajit S.} and Guglielmo Pero and Erez Nossek and Eytan Raz and Monika Killer-Oberpfalze and Ozates, {M. Ozgur} and Giyas Ayberk and Regenhardt, {Robert W.} and Griessenauer, {Christoph J.} and Hamed Asadi and Adnan Siddiqui and Ducruet, {Andrew F.} and Albuquerque, {Felipe C.} and Patel, {Nirav J.} and Stapleton, {Christopher J.} and Peter Kan and Vladimir Kalousek and Pedro Lylyk and Srikanth Boddu and Jared Knopman and Aziz-Sultan, {Mohammad A.} and Fr{\'e}d{\'e}ric Claren{\c c}on and Nicola Limbucci and Mario Zanaty and Martinez-Gutierrez, {Juan Carlos} and Sunil Sheth and Gary Spiegel and Rawad Abbas and Abdelaziz Amllay and Tjoumakaris, {Stavropoula I.} and Gooch, {Michael R.} and Herial, {Nabeel A.} and Rosenwasser, {Robert H.} and Hekmat Zarzour and Schmidt, {Richard F.} and Pereira, {Vitor Mendes} and Patel, {Aman B.} and Jabbour, {Pascal M.} and Dmytriw, {Adam A.}",

year = "2024",

month = jul,

day = "1",

doi = "10.3174/ajnr.A8324",

language = "English (US)",

volume = "45",

pages = "906--911",

journal = "American Journal of Neuroradiology",

issn = "0195-6108",

publisher = "American Society of Neuroradiology",

number = "7",

}

TY - JOUR

T1 - Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device

T2 - Results of aMulticenter Retrospective Study

AU - Mastorakos, Panagiotis

AU - El Naamani, Kareem

AU - Adeeb, Nimer

AU - Lan, Mathews

AU - Castiglione, James

AU - Khanna, Omaditya

AU - Ghosh, Ritam

AU - Diestro, Jose Danilo Bengzon

AU - Dibas, Mahmoud

AU - McLellan, Rachel M.

AU - Algin, Oktay

AU - Ghozy, Sherief

AU - Cancelliere, Nicole M.

AU - Aslan, Assala

AU - Cuellar-Saenz, Hugo H.

AU - Lay, Sovann V.

AU - Guenego, Adrien

AU - Renieri, Leonardo

AU - Carnevale, Joseph

AU - Saliou, Guillaume

AU - Shotar, Eimad

AU - Premat, Kevin

AU - Möhlenbruch, Markus

AU - Kral, Michael

AU - Vranic, Justin E.

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 - Tutino, Vincent M.

AU - Ibrahim, Mohamed K.

AU - Mohammed, Marwa A.

AU - Rabinov, James D.

AU - Ren, Yifan

AU - Schirmer, Clemens M.

AU - Piano, Mariangela

AU - Bullrich, Maria Bres

AU - Mayich, Michael

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 - Psychogios, Marios

AU - Ulfert, Christian

AU - Spears, Julian

AU - Jankowitz, Brian T.

AU - Burkhardt, Jan Karl

AU - Domingo, Ricardo A.

AU - Huynh, Thien

AU - Tawk, Rabih G.

AU - Lubicz, Boris

AU - Nawka, Marie T.

AU - Panni, Pietro

AU - Puri, Ajit S.

AU - Pero, Guglielmo

AU - Nossek, Erez

AU - Raz, Eytan

AU - Killer-Oberpfalze, Monika

AU - Ozates, M. Ozgur

AU - Ayberk, Giyas

AU - Regenhardt, Robert W.

AU - Griessenauer, Christoph J.

AU - Asadi, Hamed

AU - Siddiqui, Adnan

AU - Ducruet, Andrew F.

AU - Albuquerque, Felipe C.

AU - Patel, Nirav J.

AU - Stapleton, Christopher J.

AU - Kan, Peter

AU - Kalousek, Vladimir

AU - Lylyk, Pedro

AU - Boddu, Srikanth

AU - Knopman, Jared

AU - Aziz-Sultan, Mohammad A.

AU - Clarençon, Frédéric

AU - Limbucci, Nicola

AU - Zanaty, Mario

AU - Martinez-Gutierrez, Juan Carlos

AU - Sheth, Sunil

AU - Spiegel, Gary

AU - Abbas, Rawad

AU - Amllay, Abdelaziz

AU - Tjoumakaris, Stavropoula I.

AU - Gooch, Michael R.

AU - Herial, Nabeel A.

AU - Rosenwasser, Robert H.

AU - Zarzour, Hekmat

AU - Schmidt, Richard F.

AU - Pereira, Vitor Mendes

AU - Patel, Aman B.

AU - Jabbour, Pascal M.

AU - Dmytriw, Adam A.

PY - 2024/7/1

Y1 - 2024/7/1

N2 - BACKGROUND AND PURPOSE: Despite the numerous studies evaluating the occlusion rates of aneurysms following WEB embolization, there are limited studies identifying predictors of occlusion. Our purpose was to identify predictors of aneurysm occlusion and the need for retreatment. MATERIALS AND METHODS: This is a review of a prospectively maintained database across 30 academic institutions. We included patients with previously untreated cerebral aneurysms embolized using the WEB who had available intraprocedural data and longterm follow-up. RESULTS: We studied 763 patients with a mean age of 59.9 (SD, 11.7) years. Complete aneurysm occlusion was observed in 212/726 (29.2%) cases, and contrast stasis was observed in 485/537 (90.3%) of nonoccluded aneurysms. At the final follow-up, complete occlusion was achieved in 497/763 (65.1%) patients, and retreatment was required for 56/763 (7.3%) patients. On multivariable analysis, history of smoking, maximal aneurysm diameter, and the presence of an aneurysm wall branch were negative predictors of complete occlusion (OR, 0.5, 0.8, and 0.4, respectively). Maximal aneurysm diameter, the presence of an aneurysm wall branch, posterior circulation location, and male sex increase the chances of retreatment (OR, 1.2, 3.8, 3.0, and 2.3 respectively). Intraprocedural occlusion resulted in a 3-fold increase in the long-term occlusion rate and a 5-fold decrease in the retreatment rate (P < .001), offering a specificity of 87% and a positive predictive value of 85% for long-term occlusion. CONCLUSIONS: Intraprocedural occlusion can be used to predict the chance of long-term aneurysm occlusion and the need for retreatment after embolization with a WEB device. Smoking, aneurysm size, and the presence of an aneurysm wall branch are associated with decreased chances of successful treatment.

AB - BACKGROUND AND PURPOSE: Despite the numerous studies evaluating the occlusion rates of aneurysms following WEB embolization, there are limited studies identifying predictors of occlusion. Our purpose was to identify predictors of aneurysm occlusion and the need for retreatment. MATERIALS AND METHODS: This is a review of a prospectively maintained database across 30 academic institutions. We included patients with previously untreated cerebral aneurysms embolized using the WEB who had available intraprocedural data and longterm follow-up. RESULTS: We studied 763 patients with a mean age of 59.9 (SD, 11.7) years. Complete aneurysm occlusion was observed in 212/726 (29.2%) cases, and contrast stasis was observed in 485/537 (90.3%) of nonoccluded aneurysms. At the final follow-up, complete occlusion was achieved in 497/763 (65.1%) patients, and retreatment was required for 56/763 (7.3%) patients. On multivariable analysis, history of smoking, maximal aneurysm diameter, and the presence of an aneurysm wall branch were negative predictors of complete occlusion (OR, 0.5, 0.8, and 0.4, respectively). Maximal aneurysm diameter, the presence of an aneurysm wall branch, posterior circulation location, and male sex increase the chances of retreatment (OR, 1.2, 3.8, 3.0, and 2.3 respectively). Intraprocedural occlusion resulted in a 3-fold increase in the long-term occlusion rate and a 5-fold decrease in the retreatment rate (P < .001), offering a specificity of 87% and a positive predictive value of 85% for long-term occlusion. CONCLUSIONS: Intraprocedural occlusion can be used to predict the chance of long-term aneurysm occlusion and the need for retreatment after embolization with a WEB device. Smoking, aneurysm size, and the presence of an aneurysm wall branch are associated with decreased chances of successful treatment.

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UR - http://www.scopus.com/inward/citedby.url?scp=85198291446&partnerID=8YFLogxK

U2 - 10.3174/ajnr.A8324

DO - 10.3174/ajnr.A8324

M3 - Article

C2 - 38977286

AN - SCOPUS:85198291446

SN - 0195-6108

VL - 45

SP - 906

EP - 911

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

IS - 7

ER -

Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of aMulticenter Retrospective Study

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