Microsurgical clipping vs Woven EndoBridge (WEB) device for the management of unruptured wide-neck bifurcation aneurysms.
Clipping
Intracranial aneurysm
Wide-neck aneurysms
Woven EndoBridge device
Journal
Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
received:
30
01
2022
accepted:
28
03
2022
revised:
22
03
2022
pubmed:
12
4
2022
medline:
6
8
2022
entrez:
11
4
2022
Statut:
ppublish
Résumé
The Woven EndoBridge device (WEB) was introduced in 2010 to treat wide-neck bifurcation aneurysms (WNBAs). Three landmark studies have been conducted to assess its safety and efficacy: WEBCAST, WEBCAST 2, and French Observatory Study. However, these studies have not compared its safety and efficacy to other treatment modalities. In this study, we compare WEB versus microsurgical clipping in the management of unruptured WNBA. We conducted a retrospective study of unruptured WNBA meeting the morphological criteria to be amenable for WEB treatment operated on at our institution. Surgical morbidity, mortality, and occlusion rates were assessed. We compared our results to those reported in the cumulative population of the three WEB landmark studies at 1 year. A total of 84 patients with 89 WNBA were included. The most common aneurysm location was the middle cerebral artery bifurcation (n = 67/89, 75%). No operative mortality was observed. Morbidity comprised small-vessel vasospasm (n = 1/89, 1%) resulting in hemiparesis vs. 3% morbidity for WEB (p = .324). All but one (n = 1/89, 1%) WNBA were completely occluded vs WEB occlusion rate of 53% at 1 year, statistically significantly worse (p < .001). In our analysis, we were not able to show superiority of WEB in terms of procedural morbidity in comparison to microsurgical clipping, defined as worsening in mRS. Microsurgical clipping achieves statistically significantly higher rates of complete aneurysm occlusion, thus posing the question of whether the WEB should be presented as a viable, comparable alternative to patients amenable to surgical treatment.
Identifiants
pubmed: 35403981
doi: 10.1007/s10143-022-01781-9
pii: 10.1007/s10143-022-01781-9
pmc: PMC9349077
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2717-2722Informations de copyright
© 2022. The Author(s).
Références
Abi-Aad KR, Rahme RJ, Syal A, Patra DP, Hudson M, Richter KR, Ward JD, Knis J, Nak Y, Turcotte E, Welz ME, Winter JD, Krishna C, Chong B, Bendok BR (2021) Quality of life of patients with unruptured intracranial aneurysms before and after endovascular coiling: a HEAT trial secondary study and systematic review of the literature. World Neurosurg 146:e492–e500. https://doi.org/10.1016/J.WNEU.2020.10.120
doi: 10.1016/J.WNEU.2020.10.120
pubmed: 33127571
Alreshidi M, Cote DJ, Dasenbrock HH, Acosta M, Can A, Doucette J, Simjian T, Hulou MM, Wheeler LA, Huang K, Zaidi HA, Du R, Aziz-Sultan MA, Mekary RA, Smith TR (2018) Coiling versus microsurgical clipping in the treatment of unruptured middle cerebral artery aneurysms: a meta-analysis. Neurosurgery 83:879–889. https://doi.org/10.1093/NEUROS/NYX623
doi: 10.1093/NEUROS/NYX623
pubmed: 29438551
Cloft HJ, Joseph GJ, Tong FC, Goldstein JH, Dion JE (2000) Use of three-dimensional Guglielmi detachable coils in the treatment of wide-necked cerebral aneurysms. AJNR Am J Neuroradiol 21(7):1312–4
pubmed: 10954285
pmcid: 8174921
Fiorella D, Arthur AS, Chiacchierini R, Emery E, Molyneux A, Pierot L (2017) How safe and effective are existing treatments for wide-necked bifurcation aneurysms? Literature-based objective performance criteria for safety and effectiveness. Journal of NeuroInterventional Surgery 9:1197–1201. https://doi.org/10.1136/NEURINTSURG-2017-013223
doi: 10.1136/NEURINTSURG-2017-013223
pubmed: 28798268
Goertz L, Liebig T, Pennig L, Roman Laukamp K, Timmer M, Brinker G, Schlamann M, Goldbrunner R, Dorn F, Krischek B, Kabbasch C (2021) Woven endobridge embolization versus microsurgical clipping for unruptured anterior circulation aneurysms: A propensity score analysis. Neurosurgery 88(4):779–784. https://doi.org/10.1093/neuros/nyaa539
doi: 10.1093/neuros/nyaa539
pubmed: 33372215
Hendricks BK, Yoon JS, Yaeger K, Kellner CP, Mocco J, de Leacy RA, Ducruet AF, Lawton MT, Mascitelli JR (2020) Wide-neck aneurysms: systematic review of the neurosurgical literature with a focus on definition and clinical implications. J Neurosurg JNS 133:159–165. https://doi.org/10.3171/2019.3.JNS183160
doi: 10.3171/2019.3.JNS183160
Ihn Y-K, Kim B, Woong Jeong H, Hyun Suh S, Dong Won Y, Lee Y-J, Joon Kim D, Jeon P, Ryu C-W, Suh S, Seob Choi D, Sung Choi S, Heum Kim S, Soo Byun J, Rho J, Song Y, Sang Jeong W, Hong N, Hyun Baik S, Jin Park J, Mee Lim S, Kim J-J, Yoon W (2021) Monitoring radiation doses during diagnostic and therapeutic neurointerventional procedures: multicenter study for establishment of reference levels Ihn YK et al. Reference Doses for Interventional Neuroradiology Procedures in Korea. https://doi.org/10.5469/neuroint.2021.00437
Johnston SC, Dowd CF, Higashida RT, Lawton MT, Duckwiler GR, Gress DR (2008) Predictors of rehemorrhage after treatment of ruptured intracranial aneurysms: the Cerebral Aneurysm Rerupture After Treatment (CARAT) study. Stroke 39:120–125. https://doi.org/10.1161/STROKEAHA.107.495747
doi: 10.1161/STROKEAHA.107.495747
pubmed: 18048860
Lodi YM, Latorre JG, El-Zammar Z, Swarnkar A, Deshaies E, Fessler RD (2012) Stent assisted coiling of the ruptured wide necked intracranial aneurysm. J NeuroInterv Surg 4:281–286. https://doi.org/10.1136/NEURINTSURG-2011-010035
doi: 10.1136/NEURINTSURG-2011-010035
pubmed: 21990500
Mascitelli JR, Lawton MT, Hendricks BK, Nakaji P, Zabramski JM, Spetzler RF (2019) Analysis of wide-neck aneurysms in the barrow ruptured aneurysm trial. Clin Neurosurg 85:622–631. https://doi.org/10.1093/neuros/nyy439
doi: 10.1093/neuros/nyy439
Munich SA, Cress MC, Rangel-Castilla L, Sonig A, Ogilvy CS, Lanzino G, Petr O, Mocco J, Morone PJ, Snyder KV, Hopkins LN, Siddiqui AH, Levy EI (2018) Neck remnants and the risk of aneurysm rupture after endovascular treatment with coiling or stent-assisted coiling: much ado about nothing? Neurosurgery 84:421–427. https://doi.org/10.1093/neuros/nyy056
doi: 10.1093/neuros/nyy056
Park HS, Kwon SC, Park ES, Bum Park J, Kim MS (2019) A new definition for wide-necked cerebral aneurysms. J Cerebrovasc Endovasc Neurosurg 21(4):193–198. https://doi.org/10.7461/jcen.2019.21.4.193
doi: 10.7461/jcen.2019.21.4.193
pubmed: 32030342
pmcid: 6987033
Pierot L, Costalat V, Moret J, Szikora I, Klisch J, Herbreteau D, Holtmannspötter M, Weber W, Januel A, Liebig T, Sychra V, Strasilla C (2016) Safety and efficacy of aneurysm treatment with WEB: results of the WEBCAST study. J Neurosurg JNS 124:1250–1256. https://doi.org/10.3171/2015.2.JNS142634.J
doi: 10.3171/2015.2.JNS142634.J
Pierot L, Gubucz I, Buhk JH, Holtmannspötter M, Herbreteau D, Stockx L, Spelle L, Berkefeld J, Januel AC, Molyneux A, Byrne JV, Fiehler J, Szikora I, Barreau X (2017) Safety and efficacy of aneurysm treatment with the WEB: results of the WEBCAST 2 study. Am J Neuroradiol 38:1151–1555. https://doi.org/10.3174/ajnr.A5178
doi: 10.3174/ajnr.A5178
pubmed: 28450432
pmcid: 7960101
Pierot L, Moret J, Barreau X, Szikora I, Herbreteau D, Turjman F, Holtmannspötter M, Januel AC, Costalat V, Fiehler J, Klisch J, Gauvrit JY, Weber W, Desal H, Velasco S, Liebig T, Stockx L, Berkefeld J, Molyneux A, Byrne J, Spelle L (2018) Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series. J NeuroInterv Surg 10:556–562. https://doi.org/10.1136/neurintsurg-2017-013448
doi: 10.1136/neurintsurg-2017-013448
Pierot L, Szikora I, Barreau X, Holtmannspoetter M, Spelle L, Herbreteau D, Fiehler J, Costalat V, Klisch J, Januel AC, Weber W, Liebig T, Stockx L, Berkefeld J, Moret J, Molyneux A, Byrne J (2021) Aneurysm treatment with WEB in the cumulative population of two prospective, multicenter series: 3-year follow-up. J NeuroInterv Surg 13:363–368. https://doi.org/10.1136/neurintsurg-2020-016151
doi: 10.1136/neurintsurg-2020-016151
pubmed: 32532858
Pierot XL, Moret J, Turjman F, Herbreteau D, Raoult H, Barreau X, Velasco S, Desal H, Januel AC, Courtheoux P, Gauvrit JY, Cognard C, Molyneux A, Byrne J, Spelle L (2016) WEB French observatory. Am J Neuroradiol 37:655–659
doi: 10.3174/ajnr.A4578
Santiago-Dieppa DR, Zhou T, Pannell JS, Khalessi AA (2016) Controversies in vascular neurosurgery: aneurysm remnants. In: Veznedaroglu E (ed) Controversies in Vascular Neurosurgery. Springer International Publishing, Cham, pp 79–81
doi: 10.1007/978-3-319-27315-0_6
Solheim O, Eloqayli H, Muller TB, Unsgaard G (2006) Clinical article quality of life after treatment for incidental, unruptured intracranial aneurysms. Acta Neurochir (Wien) 148:821–830. https://doi.org/10.1007/s00701-006-0804-7
doi: 10.1007/s00701-006-0804-7
Won SY, Seifert V, Dubinski D, Kashefiolasl S, Dinc N, Bruder M, Konczalla J (2021) Short- and midterm outcome of ruptured and unruptured intracerebral wide-necked aneurysms with microsurgical treatment. Sci Rep 11:1–11. https://doi.org/10.1038/s41598-021-84339-x
doi: 10.1038/s41598-021-84339-x
Zhai X-D, Ma Y-J, Yu J-X, Wang C-X, Geng J-W, Xiang S-S, Wang J, Guan X, Li G-L, He C, Hu P, Zhang H-Q (2021) Health-related quality of life outcomes and influencing factors in patients with unruptured intracranial aneurysms after endovascular treatment. Qual Life Res 30:2843–2852. https://doi.org/10.1007/s11136-021-02904-3
doi: 10.1007/s11136-021-02904-3
pubmed: 34152576