122 Measured Aneurysm Entry Angle is an Independent Predictor of Aneurysm Occlusion with the Woven Endobridge Device

INTRODUCTION: Woven Endobridge (WEB) is a safe and effective intrasaccular flow disruptor with over 80% adequate occlusion rates. However, complete occlusion rates remain around 50-60%. Recent studies showed that sizing modifications and lateral compression correlate with occlusion rates. METHODS: This is a single center retrospective study of all cerebral aneurysms treated with WEB devices from August 2015 to December 2023 with follow-up data. We collected basic demographic, as well as follow-up data. The aneurysm entry angle was calculated by measuring the angle between the parent artery and the long axis of the aneurysm on anteroposterior as well as lateral views of 2-dimensional angiography. Independent predictors of complete aneurysm occlusion were determined using multivariate logistic regression analysis. RESULTS: Ninety-nine patients were included in our analysis. Our cohort was 80% female, with an average age of 64, was 65% Caucasian, and comprised of 35% ruptured aneurysms. The mean size of the aneurysm was 6.3 mm in height and 5.3 mm in width with a mean neck of 3.8 mm. Our cohort included 32% basilar apex aneurysms, 28% anterior communicating artery aneurysms, 17% middle cerebral artery aneurysms and 9% internal carotid artery terminus aneurysms. In our analysis, MAEA for aneurysms with complete occlusion was 121.8 degrees +/- 28.7, and MAEA for aneurysms with incomplete occlusion was 135.4 +/- 26.9 degrees (p=0.026). In our multivariate analysis, measured aneurysm entry angle was the only variable within our data set to predict complete occlusion of aneurysms treated with WEB devices at follow-up. CONCLUSIONS: Measured aneurysm entry angle is an independent predictor of complete occlusion (Raymond-Roy 1, WEB occlusion score A) in cerebral aneurysms treated with the WEB device.