Background and purpose

Flow disruption with WEB is increasingly used for the treatment of intracranial aneurysms. We examined factors leading to aneurysm occlusion and WEB shape change during a mid-term follow-up.

Materials and methods

Patients with a minimum 12-month angiographic follow-up were included. Through a univariate and multivariate analysis, independent predictors of adequate occlusion (RR1/RR2) and WEB shape change (decrease of the height of the device) were assessed.

Results

Eighty-six patients/aneurysms were included. The mean size was 5.5 mm (range: 3–11.5 mm). The most common locations were MCA (43/86 = 50%), BT (13/86 = 15.1%), and AcomA (12/86 = 14%). Twenty-one patients (21/86 = 24%) presented acute SAH. Immediate and long-term RR1/RR2 occlusion rates were 49% (42/86) and 80% (68/86), respectively. WEB shape change was detected among 22% (19/86) of cases. At the binary logistic regression, wide ostium (≥ 4 mm) (OR = 0.2, 95% CI = 0.01–1, P = 0.04) and regular aneurysm morphology (OR = 5.9, 95% CI = 1.4–24, P = 0.01) were independent factors of incomplete and adequate aneurysm occlusion, respectively. In addition, irregular morphology (OR = 5.4, 95% CI = 1.4–19, P = 0.01) and wide ostium (OR = 9.8, 95% CI = 1.6–60, P = 0.03) significantly increased the probability of the WEB shape change. Decrease of the WEB height was higher among incomplete occluded aneurysms (6/12 = 50% vs 13/74 = 17.5%), but it was not an independent prognosticator of occlusion at the multivariate model.

Conclusions

The likelihood of good occlusion was 5 times lower in the presence of a wide ostium, whereas aneurysms with regular morphology were 6 times more likely to be occluded. WEB shape modification was strongly influenced by the aneurysm shape and ostium size, and it was not independently associated with the angiographic occlusion (Fig. 1, Fig. 2, Fig. 3).

中文翻译：

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使用WEB（机织EndoBridge）设备治疗后血管造影动脉瘤闭塞的预测因素：中期随访的单中心经验

背景和目的

使用WEB中断血流越来越多地用于治疗颅内动脉瘤。我们在中期随访中检查了导致动脉瘤闭塞和WEB形状改变的因素。

材料和方法

纳入至少12个月血管造影随访的患者。通过单变量和多变量分析，评估了适当的咬合（RR1 / RR2）和WEB形状变化（设备高度降低）的独立预测因子。

结果

包括八十六例患者/动脉瘤。平均大小为5.5毫米（范围：3-11.5毫米）。最常见的位置是MCA（43/86 = 50％），BT（13/86 = 15.1％）和AcomA（12/86 = 14％）。21名患者（21/86 = 24％）出现了急性SAH。立即和长期的RR1 / RR2阻塞率分别为49％（42/86）和80％（68/86）。在22％（19/86）的病例中检测到WEB形状改变。在二元逻辑回归中，宽口（≥4 mm）（OR  = 0.2，95 ％CI = 0.01–1，P = 0.04）和规则的动脉瘤形态（OR = 5.9，95％CI = 1.4–24，P  = 0.01 ）是分别导致动脉瘤闭塞不完全和独立的独立因素。此外，形态不规则（OR = 5.4，95％CI = 1.4–19，P  = 0.01）和宽口（OR = 9.8，95％CI = 1.6-60，P  = 0.03）大大增加了WEB形状变化的可能性。在不完全闭塞的动脉瘤中，WEB高度的降低较高（6/12 = 50％比13/74 = 17.5％），但是在多变量模型中，它不是闭塞的独立预后因子。

结论

存在宽口的情况下，良好阻塞的可能性低5倍，而形态规则的动脉瘤被阻塞的可能性高6倍。WEB形状的改变在很大程度上受动脉瘤形状和孔口大小的影响，并且与血管造影的闭塞无关（图1，图2，图3）。