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Creation of a predictive calculator to determine adequacy of occlusion of the woven endobridge (WEB) device in intracranial aneurysms: A retrospective analysis of the WorldWide WEB Consortium database

Background - Endovascular treatment with the woven endobridge (WEB) device has been widely utilized for managing intracranial aneurysms. However, predicting the probability of achieving adequate occlusion (Raymond-Roy classification 1 or 2) remains challenging. - Objective - Our study sought to deve...

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Main Authors: Musmar, Basel (Author) , Adeeb, Nimer (Author) , Gendreau, Julian (Author) , Horowitz, Melanie Alfonzo (Author) , Salim, Hamza Adel (Author) , Sanmugananthan, Praveen (Author) , Aslan, Assala (Author) , Brown, Nolan J (Author) , Cancelliere, Nicole M (Author) , McLellan, Rachel M (Author) , Algin, Oktay (Author) , Ghozy, Sherief (Author) , Dibas, Mahmoud (Author) , Orscelik, Atakan (Author) , Senol, Yigit Can (Author) , Lay, Sovann V (Author) , Guenego, Adrien (Author) , Renieri, Leonardo (Author) , Carnevale, Joseph (Author) , Saliou, Guillaume (Author) , Mastorakos, Panagiotis (Author) , El Naamani, Kareem (Author) , Shotar, Eimad (Author) , Premat, Kevin (Author) , Möhlenbruch, Markus Alfred (Author) , Kral, Michael (Author) , Doron, Omer (Author) , Chung, Charlotte (Author) , Salem, Mohamed M (Author) , Lylyk, Ivan (Author) , Foreman, Paul M (Author) , Vachhani, Jay A (Author) , Shaikh, Hamza (Author) , Župančić, Vedran (Author) , Hafeez, Muhammad U (Author) , Catapano, Joshua (Author) , Waqas, Muhammad (Author) , Tutino, Vincent M (Author) , Gokhan, Yuce (Author) , Imamoglu, Cetin (Author) , Bayrak, Ahmet (Author) , Rabinov, James D (Author) , Ren, Yifan (Author) , Schirmer, Clemens M (Author) , Piano, Mariangela (Author) , Kühn, Anna L (Author) , Michelozzi, Caterina (Author) , Elens, Stéphanie (Author) , Starke, Robert M (Author) , Hassan, Ameer E (Author) , Ogilvie, Mark (Author) , Nguyen, Anh (Author) , Jones, Jesse (Author) , Brinjikji, Waleed (Author) , Nawka, Marie T (Author) , Psychogios, Marios (Author) , Ulfert, Christian (Author) , Bengzon Diestro, Jose Danilo (Author) , Pukenas, Bryan (Author) , Burkhardt, Jan-Karl (Author) , Huynh, Thien (Author) , Martinez-Gutierrez, Juan Carlos (Author) , Essibayi, Muhammed Amir (Author) , Sheth, Sunil A (Author) , Spiegel, Gary (Author) , Tawk, Rabih (Author) , Lubicz, Boris (Author) , Panni, Pietro (Author) , Puri, Ajit S (Author) , Pero, Guglielmo (Author) , Nossek, Erez (Author) , Raz, Eytan (Author) , Killer-Oberfalzer, Monika (Author) , Griessenauer, Christoph J (Author) , Asadi, Hamed (Author) , Siddiqui, Adnan (Author) , Brook, Allan L (Author) , Altschul, David (Author) , Ducruet, Andrew F (Author) , Albuquerque, Felipe C (Author) , Regenhardt, Robert W (Author) , Stapleton, Christopher J (Author) , Kan, Peter (Author) , Kalousek, Vladimir (Author) , Lylyk, Pedro (Author) , Boddu, Srikanth (Author) , Knopman, Jared (Author) , Aziz-Sultan, Mohammad A (Author) , Tjoumakaris, Stavropoula I (Author) , Clarençon, Frédéric (Author) , Limbucci, Nicola (Author) , Bydon, Mohamad (Author) , Hasan, David (Author) , Cuellar-Saenz, Hugo H (Author) , Jabbour, Pascal M (Author) , Pereira, Vitor Mendes (Author) , Patel, Aman B (Author) , Dmytriw, Adam A (Author)
Format: Article (Journal)
Published: August 10, 2024
In: Interventional neuroradiology
Year: 2024, Pages: 1-7
ISSN:2385-2011
DOI:10.1177/15910199241267320
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1177/15910199241267320
Verlag, kostenfrei, Volltext: https://journals.sagepub.com/doi/10.1177/15910199241267320
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Author Notes:Basel Musmar, Nimer Adeeb, Julian Gendreau, Melanie Alfonzo Horowitz, Hamza Adel Salim, Praveen Sanmugananthan, Assala Aslan, Nolan J Brown, Nicole M Cancelliere, Rachel M McLellan, Oktay Algin, Sherief Ghozy, Mahmoud Dibas, Atakan Orscelik, Yigit Can Senol, 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, Vincent M Tutino, Yuce Gokhan, Cetin Imamoglu, Ahmet Bayrak, 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, Marios Psychogios, Christian Ulfert, Jose Danilo Bengzon Diestro, Bryan Pukenas, Jan-Karl Burkhardt, Thien Huynh, Juan Carlos Martinez-Gutierrez, Muhammed Amir Essibayi, Sunil A Sheth, Gary Spiegel, Rabih Tawk, Boris Lubicz, Pietro Panni, Ajit S Puri, Guglielmo Pero, Erez Nossek, Eytan Raz, Monika Killer-Oberfalzer, Christoph J Griessenauer, Hamed Asadi, Adnan Siddiqui, Allan L Brook, David Altschul, Andrew F Ducruet, Felipe C Albuquerque, Robert W Regenhardt, Christopher J Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Jared Knopman, Mohammad A Aziz-Sultan, Stavropoula I Tjoumakaris, Frédéric Clarençon, Nicola Limbucci, Mohamad Bydon, David Hasan, Hugo H Cuellar-Saenz, Pascal M Jabbour, Vitor Mendes Pereira, Aman B Patel and Adam A Dmytriw

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520 |a Background - Endovascular treatment with the woven endobridge (WEB) device has been widely utilized for managing intracranial aneurysms. However, predicting the probability of achieving adequate occlusion (Raymond-Roy classification 1 or 2) remains challenging. - Objective - Our study sought to develop and validate a predictive calculator for adequate occlusion using the WEB device via data from a large multi-institutional retrospective cohort. - Methods - We used data from the WorldWide WEB Consortium, encompassing 356 patients from 30 centers across North America, South America, and Europe. Bivariate and multivariate regression analyses were performed on a variety of demographic and clinical factors, from which predictive factors were selected. Calibration and validation were conducted, with variance inflation factor (VIF) parameters checked for collinearity. - Results - A total of 356 patients were included: 124 (34.8%) were male, 108 (30.3%) were elderly (≥65 years), and 118 (33.1%) were current smokers. Mean maximum aneurysm diameter was 7.09 mm (SD 2.71), with 112 (31.5%) having a daughter sac. In the multivariate regression, increasing aneurysm neck size (OR 0.706 [95% CI: 0.535-0.929], p = 0.13) and partial aneurysm thrombosis (OR 0.135 [95% CI: 0.024-0.681], p = 0.016) were found to be the only statistically significant variables associated with poorer likelihood of achieving occlusion. The predictive calculator shows a c-statistic of 0.744. Hosmer-Lemeshow goodness-of-fit test indicated a satisfactory model fit with a p-value of 0.431. The calculator is available at: https://neurodx.shinyapps.io/WEBDEVICE/. - Conclusion - The predictive calculator offers a substantial contribution to the clinical toolkit for estimating the likelihood of adequate intracranial aneurysm occlusion by WEB device embolization. 
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