Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment: Insights from the WorldWideWEB Consortium registry
journal contribution
posted on 2025-06-03, 05:07 authored by G Saliou, HA Salim, B Musmar, N Adeeb, A Aslan, C Swaid, M Cuellar, M Dibas, NM Cancelliere, JDB Diestro, O Algin, S Ghozy, SV Lay, A Guenego, L Renieri, JA Carnevale, P Mastorakos, K Elnaamani, E Shotar, MA Möhlenbruch, M Kral, C Chung, MM Salem, I Lylyk, PM Foreman, H Shaikh, V Župančić, MU Hafeez, JS Catapano, M Waqas, M Arslan, O Ergun, JD Rabinov, Y Ren, CM Schirmer, M Piano, AL Kuhn, C Michelozzi, RM Starke, AE Hassan, M Ogilvie, A Nguyen, J Jones, W Brinjikji, MT Nawka, MN Psychogios, C Ulfert, B Pukenas, JK Burkhardt, TJ Huynh, JC Martinez-Gutierrez, MA Essibayi, SA Sheth, D Slawski, R Tawk, B Pulli, B Lubicz, P Panni, AS Puri, G Pero, E Raz, CJ Griessenauer, Hamed AsadiHamed Asadi, AH Siddiqui, EI Levy, N Haranhalli, D Altschul, AF Ducruet, FC Albuquerque, RW Regenhardt, CJ Stapleton, P Kan, V Kalousek, P Lylyk, SR Boddu, J Knopman, SI Tjoumakaris, H Cuellar, P Jabbour, F Clarençon, N Limbucci, VM Pereira, AB Patel, AA Dmytriw, SD HajduBackgroundThe 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.ObjectiveTo assess whether partially thrombosed aneurysms are at higher risk of recurrence or retreatment following WEB embolization compared with non-thrombosed aneurysms.MethodsWe 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.ResultsAmong 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).ConclusionPartially 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.
