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Comparison of Angiographic Outcomes of Woven EndoBridge and Balloon-Assisted Coiling for the Treatment of Ruptured Wide-Necked Aneurysms: A Multicentric Study
Journal article   Open access   Peer reviewed

Comparison of Angiographic Outcomes of Woven EndoBridge and Balloon-Assisted Coiling for the Treatment of Ruptured Wide-Necked Aneurysms: A Multicentric Study

Aaron Rodriguez-Calienes, Juan Vivanco-Suarez, Milagros Galecio-Castillo, Mahmoud Dibas, Bradley Gross, Mudassir Farooqui, Oktay Algin, Turker Kilic, Yasin Celal Gunes, Chaim Feigen, …
Stroke: vascular and interventional neurology, Vol.4(3), 001233
05/01/2024
DOI: 10.1161/SVIN.123.001233
PMCID: PMC12778502
PMID: 41584485
Appears in  UI Libraries Support Open Access
url
https://doi.org/10.1161/SVIN.123.001233View
Published (Version of record) Open Access

Abstract

Background The optimal endovascular approach for acutely ruptured wide-neck intracranial aneurysms remains uncertain, and the use of stent-assisted coiling or flow diversion is controversial due to antiplatelet therapy requirements and potential risks. Various techniques have been developed to address these challenges, including balloon-assisted coiling (BAC) and intrasaccular flow-disruption. The Woven EndoBridge (WEB) is an intrasaccular device that has shown a favorable efficacy and safety profile for ruptured aneurysms with minimal rebleeding rates. We aimed to compare the clinical and radiological outcomes between WEB and BAC in a cohort of patients with ruptured wide-necked intracranial aneurysms.Methods In this international multicenter cohort study, we included consecutive patients treated for ruptured wide-neck intracranial aneurysms with either WEB or BAC at 4 neurovascular centers. The primary effectiveness outcome was complete aneurysm occlusion at the final imaging follow-up using the Raymond-Roy scale. Secondary outcomes included a composite of periprocedural hemorrhagic/ischemia-related complications and favorable functional outcome.Results The study included 104 patients treated with WEB and 107 patients treated with BAC. Of the patients, 60.5% in the WEB group and 53% in the BAC group achieved complete occlusion, with no significant difference between the 2 groups after adjusting for covariates (adjusted odds ratio [OR] = 1.02; 95% CI 0.46-2.25; P = 0.964). The odds of favorable functional outcome did not significantly differ between the WEB (74.8%) and BAC groups (77.4%, adjusted OR = 1.45; 95% CI 0.65-3.24; P = 0.368). Procedure-related complications were similar in both groups (WEB: 9.6%, BAC: 10.3%, P = 0.872), with no significant difference observed in the rates of ischemic events (WEB: 6.7% versus BAC: 2.8%; P = 0.180) and hemorrhagic events (WEB: 3.8% versus BAC: 7.5%; P = 0.255) between the 2 groups.Conclusion In conclusion, both WEB and BAC techniques showed similar effectiveness and safety outcomes in treating ruptured wide-neck intracranial aneurysms. Further prospective comparative studies are needed to better guide treatment decisions for this patient population.
 Cerebral Aneurysm Intracranial Hemorrhage UIOWA OA Agreement

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