Purpose

Endovascular therapy with the Woven EndoBridge (WEB) device is a safe treatment approach, whereby neoendothelialization at the neck area is a crucial element for aneurysm occlusion. We hypothesized that WEB sizing at the aneurysmal neck level has an impact on early aneurysm occlusion.

Methods

Patients with short-term follow-up digital subtraction angiography following WEB treatment of unruptured aneurysms were included. Aneurysms were categorized according to the Bicêtre Occlusion Scale Score (BOSS) as adequately (BOSS 0, 0′, 1) or partially occluded (BOSS 2, 3, 1 + 3). The WEB device dimensions, including the average aneurysm diameter (AADi) and the average neck diameter (ANDi) as well as baseline patient characteristics were documented.

Results

In this study 75 patients with 76 aneurysms were included and 65 aneurysms showed adequate occlusion at short-term follow-up (86%). In univariable logistic regression analysis, smaller differences in WEB size to ANDi (D-ANDi) were significantly associated with adequate aneurysm occlusion (odds ratio, OR = 0.41, 95% confidence interval, CI 0.23–0.71, p = 0.002). Receiver operating characteristic (ROC) curve analyses displayed higher discriminative power for the D‑ANDi (AUC = 0.77, 95% CI 0.66–0.86, cut-off ≤2.9 mm) compared to the difference in WEB size to the average aneurysm diameter (D-AADi, AUC = 0.65, 95% CI 0.53–0.75, cut-off ≤1.0 mm).

Conclusion

Smaller differences between the WEB width and ANDi were associated with adequate early aneurysm occlusion and might thus have a higher impact on the results than the traditional device sizing considering the mean aneurysm diameter. D‑ANDi ≤2.9 mm served as an optimal cut-off to classify occlusion after WEB treatment at the short-term follow-up. Further external validation is warranted.

中文翻译：

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动脉瘤颈部水平的编织 EndoBridge (WEB) 宽度影响早期血管造影动脉瘤闭塞

目的

使用 Woven EndoBridge (WEB) 装置的血管内治疗是一种安全的治疗方法，颈部区域的新内皮化是动脉瘤闭塞的关键因素。我们假设动脉瘤颈部水平的 WEB 大小对早期动脉瘤闭塞有影响。

方法

纳入未破裂动脉瘤 WEB 治疗后短期随访数字减影血管造影的患者。根据 Bicêtre 闭塞量表评分 (BOSS) 将动脉瘤分类为充分闭塞 (BOSS 0, 0', 1) 或部分闭塞 (BOSS 2, 3, 1 + 3)。记录了 WEB 设备尺寸，包括平均动脉瘤直径 (AADi) 和平均颈部直径 (ANDi) 以及基线患者特征。

结果

在这项研究中，75 名患者的 76 个动脉瘤被纳入，65 个动脉瘤在短期随访中显示出充分的闭塞（86%）。在单变量逻辑回归分析中，WEB 大小与 ANDi (D-ANDi) 的较小差异与充分的动脉瘤闭塞显着相关（优势比，OR = 0.41，95% 置信区间，CI 0.23–0.71，p  = 0.002）。受试者工作特征 (ROC) 曲线分析显示，与 WEB 大小与平均动脉瘤直径 (D -AADi，AUC = 0.65，95% CI 0.53–0.75，截止值≤1.0 mm）。

结论

WEB 宽度和 ANDi 之间的较小差异与充分的早期动脉瘤闭塞有关，因此可能比考虑平均动脉瘤直径的传统装置尺寸对结果的影响更大。D‑ANDi ≤2.9 mm 作为短期随访 WEB 治疗后对闭塞进行分类的最佳截止值。需要进一步的外部验证。