Impact of Woven EndoBridge Shape Modification on Aneurysm Recanalization at Short-Term Follow-up Digital Subtraction Angiography
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Impact of Woven EndoBridge Shape Modification on Aneurysm Recanalization at Short-Term Follow-up Digital Subtraction Angiography. / Nawka, Marie Teresa; Fiehler, Jens; Bester, Maxim; Broocks, Gabriel.
In: NEUROSURGERY, Vol. 90, No. 5, 01.05.2022, p. 597-604.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of Woven EndoBridge Shape Modification on Aneurysm Recanalization at Short-Term Follow-up Digital Subtraction Angiography
AU - Nawka, Marie Teresa
AU - Fiehler, Jens
AU - Bester, Maxim
AU - Broocks, Gabriel
N1 - Copyright © Congress of Neurological Surgeons 2022. All rights reserved.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - BACKGROUND: Woven EndoBridge (WEB) shape modification (WSM) is a frequently observed phenomenon after aneurysm embolization.OBJECTIVE: To test our hypothesis that WSM is associated with worse aneurysm occlusion on short-term angiographic follow-up images.METHODS: Patients with short-term follow-up digital subtraction angiography (DSA) available were included. Baseline patient characteristics, aneurysm morphometrics, and WEB dimensions ("conventional" parameters) and height and width WSM ("WSM" parameters) in the initial and the follow-up examination were analyzed. For ordinal regression analyses, aneurysm occlusion was graded according to the Bicêtre Occlusion Scale Score (BOSS; grades 0, 0', 1, 2, 3, and 1 + 3). Receiver operating characteristic curve analysis was used to distinguish adequately (BOSS 0, 0', and 1) from incompletely (BOSS 2, 3, and 1 + 3) occluded aneurysms.RESULTS: We included 93 patients with 96 aneurysms. Adequate occlusion was observed in 72 cases (75.0%). In univariate ordinal regression analysis, width WSM in anteroposterior DSA (odds ratio = 0.96, 95% CI: 0.94-0.99, P = .010) and in lateral DSA (odds ratio = 0.98, 95% CI: 0.97-0.99, P = .049) were significantly associated with the BOSS after 6 months. In multivariate regression analysis, WSM was not independently associated with aneurysm occlusion. Based on receiver operating characteristic curve analysis, the area under the curve (AUC) of the "conventional" model (AUC = 0.83, 95% CI 0.74-0.90) was higher than the AUC of the "WSM" model (WSM; AUC = 0.70, 95% CI 0.60-0.79).CONCLUSION: WSM was not independently associated with angiographic aneurysm occlusion status after 6 months. However, the "conventional" parameters including sex, rupture state, WEB type, WEB width, aneurysm width, height, and volume were associated with partial aneurysm recanalization in WEB-treated patients at the short-term follow-up.
AB - BACKGROUND: Woven EndoBridge (WEB) shape modification (WSM) is a frequently observed phenomenon after aneurysm embolization.OBJECTIVE: To test our hypothesis that WSM is associated with worse aneurysm occlusion on short-term angiographic follow-up images.METHODS: Patients with short-term follow-up digital subtraction angiography (DSA) available were included. Baseline patient characteristics, aneurysm morphometrics, and WEB dimensions ("conventional" parameters) and height and width WSM ("WSM" parameters) in the initial and the follow-up examination were analyzed. For ordinal regression analyses, aneurysm occlusion was graded according to the Bicêtre Occlusion Scale Score (BOSS; grades 0, 0', 1, 2, 3, and 1 + 3). Receiver operating characteristic curve analysis was used to distinguish adequately (BOSS 0, 0', and 1) from incompletely (BOSS 2, 3, and 1 + 3) occluded aneurysms.RESULTS: We included 93 patients with 96 aneurysms. Adequate occlusion was observed in 72 cases (75.0%). In univariate ordinal regression analysis, width WSM in anteroposterior DSA (odds ratio = 0.96, 95% CI: 0.94-0.99, P = .010) and in lateral DSA (odds ratio = 0.98, 95% CI: 0.97-0.99, P = .049) were significantly associated with the BOSS after 6 months. In multivariate regression analysis, WSM was not independently associated with aneurysm occlusion. Based on receiver operating characteristic curve analysis, the area under the curve (AUC) of the "conventional" model (AUC = 0.83, 95% CI 0.74-0.90) was higher than the AUC of the "WSM" model (WSM; AUC = 0.70, 95% CI 0.60-0.79).CONCLUSION: WSM was not independently associated with angiographic aneurysm occlusion status after 6 months. However, the "conventional" parameters including sex, rupture state, WEB type, WEB width, aneurysm width, height, and volume were associated with partial aneurysm recanalization in WEB-treated patients at the short-term follow-up.
KW - Angiography, Digital Subtraction/methods
KW - Cerebral Angiography
KW - Embolization, Therapeutic/methods
KW - Endovascular Procedures/methods
KW - Follow-Up Studies
KW - Humans
KW - Intracranial Aneurysm/diagnostic imaging
KW - Retrospective Studies
KW - Treatment Outcome
U2 - 10.1227/neu.0000000000001889
DO - 10.1227/neu.0000000000001889
M3 - SCORING: Journal article
C2 - 35225244
VL - 90
SP - 597
EP - 604
JO - NEUROSURGERY
JF - NEUROSURGERY
SN - 0148-396X
IS - 5
ER -
