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

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. - - -...

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Main Authors: Saliou, Guillaume (Author) , Salim, Hamza Adel (Author) , Musmar, Basel (Author) , Adeeb, Nimer (Author) , Aslan, Assala (Author) , Swaid, Christian (Author) , Cuellar, Miguel (Author) , Dibas, Mahmoud (Author) , Cancelliere, Nicole M (Author) , Diestro, Jose Danilo Bengzon (Author) , Algin, Oktay (Author) , Ghozy, Sherief (Author) , Lay, Sovann V (Author) , Guenego, Adrien (Author) , Renieri, Leonardo (Author) , Carnevale, Joseph Anthony (Author) , Mastorakos, Panagiotis (Author) , ElNaamani, Kareem (Author) , Shotar, Eimad (Author) , Möhlenbruch, Markus Alfred (Author) , Kral, Michael (Author) , Chung, Charlotte (Author) , Salem, Mohamed M (Author) , Lylyk, Ivan (Author) , Foreman, Paul M (Author) , Shaikh, Hamza (Author) , Župančić, Vedran (Author) , Hafeez, Muhammad Ubaid (Author) , Catapano, Joshua S (Author) , Waqas, Muhammad (Author) , Arslan, Muhammet (Author) , Ergun, Onur (Author) , Rabinov, James D (Author) , Ren, Yifan (Author) , Schirmer, Clemens M (Author) , Piano, Mariangela (Author) , Kuhn, Anna Luisa (Author) , Michelozzi, Caterina (Author) , Starke, Robert M (Author) , Hassan, Ameer E (Author) , Ogilvie, Mark (Author) , Nguyen, Anh (Author) , Jones, Jesse (Author) , Brinjikji, Waleed (Author) , Nawka, Marie Teresa (Author) , Psychogios, Marios-Nikos (Author) , Ulfert, Christian (Author) , Pukenas, Bryan (Author) , Burkhardt, Jan Karl (Author) , Huynh, Thien J (Author) , Martinez-Gutierrez, Juan Carlos (Author) , Essibayi, Muhammed Amir (Author) , Sheth, Sunil A (Author) , Slawski, Diana (Author) , Tawk, Rabih (Author) , Pulli, Benjamin (Author) , Lubicz, Boris (Author) , Panni, Pietro (Author) , Puri, Ajit S (Author) , Pero, Guglielmo (Author) , Raz, Eytan (Author) , Griessenauer, Christoph J (Author) , Asadi, Hamed (Author) , Siddiqui, Adnan H (Author) , Levy, Elad I (Author) , Haranhalli, Neil (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 Reddy (Author) , Knopman, Jared (Author) , Tjoumakaris, Stavropoula I (Author) , Cuellar, Hugo (Author) , Jabbour, Pascal (Author) , Clarençon, Frédéric (Author) , Limbucci, Nicola (Author) , Pereira, Vitor M (Author) , Patel, Aman B (Author) , Dmytriw, Adam A (Author) , Hajdu, Steven D (Author)
Format: Article (Journal)
Language:English
Published: 29 April 2025
In: Journal of neuroInterventional surgery
Year: 2026, Volume: 18, Issue: 3, Pages: 782-789
ISSN:1759-8486
DOI:10.1136/jnis-2024-022628
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1136/jnis-2024-022628
Verlag, kostenfrei, Volltext: https://jnis.bmj.com/lookup/doi/10.1136/jnis-2024-022628
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Author Notes: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

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245 1 0 |a Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment  |b insights from the WorldWideWEB Consortium registry  |c 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 
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520 |a 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. 
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