Creation of a predictive calculator to determine adequacy of occlusion of the woven endobridge (WEB) device in intracranial aneurysms—A retrospective analysis of the WorldWide WEB Consortium database

Musmar, B.; Adeeb, N.; Gendreau, J.; Horowitz, M. A.; Salim, H. A.; Sanmugananthan, P.; Aslan, A.; Brown, N. J.; Cancelliere, N. M.; Mclellan, R. M.; Algin, O.; Ghozy, S.; Dibas, M.; Orscelik, A.; Senol, Y. C.; Lay, S. V.; Guenego, A.; Renieri, L.; Carnevale, J.; Saliou, G.; Mastorakos, P.; El Naamani, K.; Shotar, E.; Premat, K.; Mohlenbruch, M.; Kral, M.; Doron, O.; Chung, C.; Salem, M. M.; Lylyk, I.; Foreman, P. M.; Vachhani, J. A.; Shaikh, H.; Zupancic, V.; Hafeez, M. U.; Catapano, J.; Waqas, M.; Tutino, V. M.; Gokhan, Y.; Imamoglu, C.; Bayrak, A.; Rabinov, J. D.; Ren, Y.; Schirmer, C. M.; Piano, M.; Kuhn, A. L.; Michelozzi, C.; Elens, S.; Starke, R. M.; Hassan, A. E.; Ogilvie, M.; Nguyen, A.; Jones, J.; Brinjikji, W.; Nawka, M. T.; Psychogios, M.; Ulfert, C.; Bengzon Diestro, J. D.; Pukenas, B.; Burkhardt, J. -K.; Huynh, T.; Martinez-Gutierrez, J. C.; Essibayi, M. A.; Sheth, S. A.; Spiegel, G.; Tawk, R.; Lubicz, B.; Panni, P.; Puri, A. S.; Pero, G.; Nossek, E.; Raz, E.; Killer-Oberfalzer, M.; Griessenauer, C. J.; Asadi, H.; Siddiqui, A.; Brook, A. L.; Altschul, D.; Ducruet, A. F.; Albuquerque, F. C.; Regenhardt, R. W.; Stapleton, C. J.; Kan, P.; Kalousek, V.; Lylyk, P.; Boddu, S.; Knopman, J.; Aziz-Sultan, M. A.; Tjoumakaris, S. I.; Clarencon, F.; Limbucci, N.; Bydon, M.; Hasan, D.; Cuellar-Saenz, H. H.; Jabbour, P. M.; Pereira, V. M.; Patel, A. B.; Dmytriw, A. A.

doi:10.1177/15910199241267320

Background: Endovascular treatment with the woven endobridge (WEB) device has been widely utilized for managing intracranial aneurysms. However, predicting the probability of achieving adequate occlusion (Raymond–Roy classification 1 or 2) remains challenging. Objective: Our study sought to develop and validate a predictive calculator for adequate occlusion using the WEB device via data from a large multi-institutional retrospective cohort. Methods: We used data from the WorldWide WEB Consortium, encompassing 356 patients from 30 centers across North America, South America, and Europe. Bivariate and multivariate regression analyses were performed on a variety of demographic and clinical factors, from which predictive factors were selected. Calibration and validation were conducted, with variance inflation factor (VIF) parameters checked for collinearity. Results: A total of 356 patients were included: 124 (34.8%) were male, 108 (30.3%) were elderly (≥65 years), and 118 (33.1%) were current smokers. Mean maximum aneurysm diameter was 7.09 mm (SD 2.71), with 112 (31.5%) having a daughter sac. In the multivariate regression, increasing aneurysm neck size (OR 0.706 [95% CI: 0.535–0.929], p = 0.13) and partial aneurysm thrombosis (OR 0.135 [95% CI: 0.024–0.681], p = 0.016) were found to be the only statistically significant variables associated with poorer likelihood of achieving occlusion. The predictive calculator shows a c-statistic of 0.744. Hosmer–Lemeshow goodness-of-fit test indicated a satisfactory model fit with a p-value of 0.431. The calculator is available at: https://neurodx.shinyapps.io/WEBDEVICE/. Conclusion: The predictive calculator offers a substantial contribution to the clinical toolkit for estimating the likelihood of adequate intracranial aneurysm occlusion by WEB device embolization.

Creation of a predictive calculator to determine adequacy of occlusion of the woven endobridge (WEB) device in intracranial aneurysms—A retrospective analysis of the WorldWide WEB Consortium database / Musmar, B.; Adeeb, N.; Gendreau, J.; Horowitz, M. A.; Salim, H. A.; Sanmugananthan, P.; Aslan, A.; Brown, N. J.; Cancelliere, N. M.; Mclellan, R. M.; Algin, O.; Ghozy, S.; Dibas, M.; Orscelik, A.; Senol, Y. C.; Lay, S. V.; Guenego, A.; Renieri, L.; Carnevale, J.; Saliou, G.; Mastorakos, P.; El Naamani, K.; Shotar, E.; Premat, K.; Mohlenbruch, M.; Kral, M.; Doron, O.; Chung, C.; Salem, M. M.; Lylyk, I.; Foreman, P. M.; Vachhani, J. A.; Shaikh, H.; Zupancic, V.; Hafeez, M. U.; Catapano, J.; Waqas, M.; Tutino, V. M.; Gokhan, Y.; Imamoglu, C.; Bayrak, A.; Rabinov, J. D.; Ren, Y.; Schirmer, C. M.; Piano, M.; Kuhn, A. L.; Michelozzi, C.; Elens, S.; Starke, R. M.; Hassan, A. E.; Ogilvie, M.; Nguyen, A.; Jones, J.; Brinjikji, W.; Nawka, M. T.; Psychogios, M.; Ulfert, C.; Bengzon Diestro, J. D.; Pukenas, B.; Burkhardt, J. -K.; Huynh, T.; Martinez-Gutierrez, J. C.; Essibayi, M. A.; Sheth, S. A.; Spiegel, G.; Tawk, R.; Lubicz, B.; Panni, P.; Puri, A. S.; Pero, G.; Nossek, E.; Raz, E.; Killer-Oberfalzer, M.; Griessenauer, C. J.; Asadi, H.; Siddiqui, A.; Brook, A. L.; Altschul, D.; Ducruet, A. F.; Albuquerque, F. C.; Regenhardt, R. W.; Stapleton, C. J.; Kan, P.; Kalousek, V.; Lylyk, P.; Boddu, S.; Knopman, J.; Aziz-Sultan, M. A.; Tjoumakaris, S. I.; Clarencon, F.; Limbucci, N.; Bydon, M.; Hasan, D.; Cuellar-Saenz, H. H.; Jabbour, P. M.; Pereira, V. M.; Patel, A. B.; Dmytriw, A. A.. - In: INTERVENTIONAL NEURORADIOLOGY. - ISSN 1591-0199. - (2024). [10.1177/15910199241267320]