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.
Publication/Presentation Date
12-2-2025
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.
Volume
49
Issue
1
First Page
36
Last Page
36
ISSN
1437-2320
Published In/Presented At
Essibayi, M. A., Jabal, M. S., Jamil, H., Salim, H. A., Musmar, B., Adeeb, N., Dibas, M., Cancelliere, N. M., Diestro, J. D. B., Algin, O., Ghozy, S., Lay, S. V., Guenego, A., Renieri, L., Carnevale, J., Saliou, G., Mastorakos, P., Naamani, K. E., Momin, A. A., Shotar, E., … WorldWideWEB Consortium Collaborators (2025). 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. Neurosurgical review, 49(1), 36. https://doi.org/10.1007/s10143-025-03928-w
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41326865
Department(s)
Administration and Leadership
Document Type
Article