Factors influencing immediate post-angiographic occlusion outcomes in intracranial aneurysms treated with the woven endobridge device: a multi-center analysis and predictive model from the WorldWideWEB consortium

The Woven EndoBridge (WEB) device treats wide-necked bifurcation aneurysms, but occlusion rates vary. This study aims to identify factors associated with immediate WEB device occlusion. Data from patients treated with WEB devices across 36 sites were analyzed. Machine learning algorithms and ordinal regression models were developed to predict immediate incomplete occlusion for ruptured and unruptured aneurysms. The study included 1565 patients, with 436 ruptured and 1129 unruptured aneurysms. Immediate complete occlusion was achieved in 38.3% of ruptured and 32.8% of unruptured aneurysms. For ruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.69. Key predictors of incomplete occlusion included pretreatment mRS, aneurysm diameter, and MCA location. Ordinal regression revealed that smoking history (OR: 1.95, p < 0.001), neck diameter (Odds Ratio [OR]: 1.50, p < 0.001), and presence of a branch from the aneurysm (OR: 2.06, p = 0.016) were associated with incomplete, while bifurcation aneurysms (OR: 0.55, p = 0.017) were associated with complete immediate occlusion. For unruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.68. Significant predictors of immediate incomplete occlusion included aneurysm neck width, MCA location, and presence of daughter sac. Ordinal regression revealed that smoking history (OR: 1.29, p = 0.032), neck diameter (OR: 1.24, p < 0.001), and presence of a daughter sac (OR: 1.53, p = 0.005) were associated with incomplete, while bifurcation aneurysms (OR: 0.71, p = 0.02) and posterior circulation location (OR: 0.68, p = 0.01) were associated with complete immediate occlusion. Careful evaluation of patient demographics and specific aneurysm characteristics may help improve the outcomes of intracranial aneurysms treated with WEB device.

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Journal
Neurosurgical Review
Published
2025-12-02
DOI
https://doi.org/10.1007/s10143-025-03928-w
Citations
2
Primary Topic
Intracranial Aneurysms: Treatment and Complications
Type
article
Field-Weighted Citation Impact
2.78
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article

Factors influencing immediate post-angiographic occlusion outcomes in intracranial aneurysms treated with the woven endobridge device: a multi-center analysis and predictive model from the WorldWideWEB consortium

Sunil A. Sheth, Alex Brehm, Joshua S. Catapano, Mohammad Ali Aziz‐Sultan et al.
2 citations
Neurosurgical Review
Intracranial Aneurysms: Treatment and Complications
2.78
article

Factors influencing immediate post-angiographic occlusion outcomes in intracranial aneurysms treated with the woven endobridge device: a multi-center analysis and predictive model from the WorldWideWEB consortium

Sunil A. Sheth, Alex Brehm, Joshua S. Catapano, Mohammad Ali Aziz‐Sultan, Eytan Raz, Thien J Huynh, Jose Danilo Bengzon Diestro, Assala Aslan, Steven Hajdu, R Brehm, Oktay Algın, Justin E. Vranic, Marwa A. Mohammed, Benjamin Pulli, Vedran Župančić, Muhammad Ubaid Hafeez, Neil Haranhalli, Guillaume Saliou, Mohamed Sobhi Jabal, Mark Ogilvie, Christoph J. Griessenauer, Hamed Asadi, Hamza Adel Salim, Sovann V. Lay, Elad I. Levy, Guglielmo Pero, Charlotte Y. Chung, Pietro Panni, James D. Rabinov, Stavropoula I. Tjoumakaris, Nimer Adeeb, Juan Carlos Martínez-Gutiérrez, Deepak Khatri, David Altschul, Christopher J. Stapleton, Rabih G. Tawk, Shervin Mirshahi, Paul M. Foreman, Ozgur Ozates, Muhammed Amir Essibayi, Boris Lubicz, Srikanth Boddu, Yasin Celal Güneş, Jesse George Atherton Jones, Stéphanie Elens, Mahmoud Dibas, Clemens M. Schirmer, Iván Lylyk, Nicole M Cancelliere, Anna Luisa Kühn, Adam Andrew Dmytriw, Mohamed M Salem, Mohamed K. Ibrahim, Jay A. Vachhani, Kévin Premat, Sherief Ghozy, Vincent M. Tutino, Bruno Bartolini, Leonardo Renieri, Waleed Brinjikji, Peter Kan, Anh Nguyên, Diana Slawski, Christian Ulfert, Yasuaki Inoue, Nicola Limbucci, Joseph A. Carnevale, Caterina Michelozzi, Marie Teresa Nawka, Robert William Regenhardt, Pascal M. Jabbour, Frédéric Clarençon, Vladimir Kalousek, Felipe C. Albuquerque, Panagiotis Mastorakos, Francesco Puccinelli, Arbaz A. Momin, Andrew F. Ducruet, Gıyas Ayberk, Julian Maingard, Michael Kral, Martin Cuellar Torriente, Ameer E Hassan, Ali Al Balushi, Omer Doron, Sri Hari Sundararajan, Jared Knopman, Adrien Guenego, Jan‐Karl Burkhardt, Mariangela Piano, Basel Musmar, Muhammed Said Beşler, Eimad Shotar, Aman B. Patel, Monika Killer-Oberfalzer, Muhammad Waqas, Pedro Lylyk, Julian Spears, Markus Möhlenbruch, Adnan Siddiqui, Christian Swaid, Ajit S. Puri, Hamza Shaikh, Hugo H. Cuellar-Saenz, Hikmet Jamil, Robert M Starke, Bryan Pukenas, Vitor Mendes Pereira, Kareem El Naamani, Marios Psychogios, Peter SpornsErez Nossek
article en
2 citations

Abstract

The Woven EndoBridge (WEB) device treats wide-necked bifurcation aneurysms, but occlusion rates vary. This study aims to identify factors associated with immediate WEB device occlusion. Data from patients treated with WEB devices across 36 sites were analyzed. Machine learning algorithms and ordinal regression models were developed to predict immediate incomplete occlusion for ruptured and unruptured aneurysms. The study included 1565 patients, with 436 ruptured and 1129 unruptured aneurysms. Immediate complete occlusion was achieved in 38.3% of ruptured and 32.8% of unruptured aneurysms. For ruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.69. Key predictors of incomplete occlusion included pretreatment mRS, aneurysm diameter, and MCA location. Ordinal regression revealed that smoking history (OR: 1.95, p < 0.001), neck diameter (Odds Ratio [OR]: 1.50, p < 0.001), and presence of a branch from the aneurysm (OR: 2.06, p = 0.016) were associated with incomplete, while bifurcation aneurysms (OR: 0.55, p = 0.017) were associated with complete immediate occlusion. For unruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.68. Significant predictors of immediate incomplete occlusion included aneurysm neck width, MCA location, and presence of daughter sac. Ordinal regression revealed that smoking history (OR: 1.29, p = 0.032), neck diameter (OR: 1.24, p < 0.001), and presence of a daughter sac (OR: 1.53, p = 0.005) were associated with incomplete, while bifurcation aneurysms (OR: 0.71, p = 0.02) and posterior circulation location (OR: 0.68, p = 0.01) were associated with complete immediate occlusion. Careful evaluation of patient demographics and specific aneurysm characteristics may help improve the outcomes of intracranial aneurysms treated with WEB device.

Neurosurgical ReviewVol. 49(1)
Geisinger Medical Center (US), St. Michael's Hospital (CA), Albert Einstein College of Medicine (US), Barrow Neurological Institute (US), Montefiore Medical Center (US), NewYork–Presbyterian Hospital (US), Harvard University (US), Johns Hopkins University (US), University of Miami (US), Orlando Health (US), Ankara University (TR), Universität Hamburg (DE), University of Toronto (CA), Cornell University (US), Heidelberg University (DE), Louisiana State University in Shreveport (US), Thomas Jefferson University Hospital (US), New York Hospital Queens (US), Erasmus Hospital (BE), University Hospital Heidelberg (DE), Centre Hospitalier Universitaire Vaudois (CH), WinnMed (US), University Hospital of Basel (CH), Johns Hopkins Bayview Medical Center (US), Centre Hospitalier Universitaire de Toulouse (FR), University of Alabama at Birmingham (US), Sorbonne Université (FR), NYU Langone Health (US), Türkiye Yüksek İhtisas Hastanesi (TR), Massachusetts General Hospital (US), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Presbyterian Hospital (US), Christian Doppler Klinik (AT), Baylor School (US), University Medical Center Hamburg-Eppendorf (DE), Pitié-Salpêtrière Hospital (FR), Mayo Clinic in Arizona (US), Valley Baptist Medical Center (US), IRCCS Ospedale San Raffaele (IT), Mayo Clinic in Florida (US), Neurological Surgery (US), Memorial Hospital (US), Austin Health (AU), Kahramanmaraş Sütçü İmam University (TR), University at Buffalo, State University of New York (US), University of Pennsylvania (US), The University of Texas Health Science Center at Houston (US), Stanford University (US)
Openalex Percentile: Top 8%
Intracranial Aneurysms: Treatment and Complications
2.78
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