Document Type
Article
Publication Date
12-2-2025
Abstract
The Woven EndoBridge (WEB) device treats wide-necked bifurcation aneurysms, but occlusion rates vary. This study aims to identify factors associated with immediate WEB device occlusion. Data from patients treated with WEB devices across 36 sites were analyzed. Machine learning algorithms and ordinal regression models were developed to predict immediate incomplete occlusion for ruptured and unruptured aneurysms. The study included 1565 patients, with 436 ruptured and 1129 unruptured aneurysms. Immediate complete occlusion was achieved in 38.3% of ruptured and 32.8% of unruptured aneurysms. For ruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.69. Key predictors of incomplete occlusion included pretreatment mRS, aneurysm diameter, and MCA location. Ordinal regression revealed that smoking history (OR: 1.95, p < 0.001), neck diameter (Odds Ratio [OR]: 1.50, p < 0.001), and presence of a branch from the aneurysm (OR: 2.06, p = 0.016) were associated with incomplete, while bifurcation aneurysms (OR: 0.55, p = 0.017) were associated with complete immediate occlusion. For unruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.68. Significant predictors of immediate incomplete occlusion included aneurysm neck width, MCA location, and presence of daughter sac. Ordinal regression revealed that smoking history (OR: 1.29, p = 0.032), neck diameter (OR: 1.24, p < 0.001), and presence of a daughter sac (OR: 1.53, p = 0.005) were associated with incomplete, while bifurcation aneurysms (OR: 0.71, p = 0.02) and posterior circulation location (OR: 0.68, p = 0.01) were associated with complete immediate occlusion. Careful evaluation of patient demographics and specific aneurysm characteristics may help improve the outcomes of intracranial aneurysms treated with WEB device.
Recommended Citation
Essibayi, Muhammed Amir; Jabal, Mohamed Sobhi; Jamil, Hasan; Salim, Hamza Adel; Musmar, Basel; Adeeb, Nimer; Dibas, Mahmoud; Cancelliere, Nicole M.; Diestro, Jose Danilo Bengzon; Algin, Oktay; Ghozy, Sherief; Lay, Sovann V.; Guenego, Adrien; Renieri, Leonardo; Carnevale, Joseph; Saliou, Guillaume; Mastorakos, Panagiotis; El Naamani, Kareem; Momin, Arbaz A.; Shotar, Eimad; Möhlenbruch, Markus; Kral, Michael; Chung, Charlotte; Salem, Mohamed M.; Lylyk, Ivan; Foreman, Paul M.; Shaikh, Hamza; Župančić, Vedran; Hafeez, Muhammad U.; Catapano, Joshua; Waqas, Muhammad; Besler, Muhammed Said; Gunes, Yasin Celal; Rabinov, James D.; Maingard, Julian; Schirmer, Clemens M.; Piano, Mariangela; Kühn, Anna L.; Michelozzi, Caterina; Starke, Robert M.; Hassan, Ameer; Ogilvie, Mark; Nguyen, Anh; Jones, Jesse; Brinjikji, Waleed; Nawka, Marie T.; Psychogios, Marios; Ulfert, Christian; Pukenas, Bryan; Burkhardt, Jan-Karl; Huynh, Thien; Martinez-Gutierrez, Juan Carlos; Sheth, Sunil A.; Slawski, Diana; Tawk, Rabih; Pulli, Benjamin; Lubicz, Boris; Panni, Pietro; Puri, Ajit S.; Pero, Guglielmo; Raz, Eytan; Griessenauer, Christoph J.; Asadi, Hamed; Siddiqui, Adnan; Levy, Elad I.; Khatri, Deepak; Haranhalli, Neil; Ducruet, Andrew F.; Albuquerque, Felipe C.; Regenhardt, Robert W.; Stapleton, Christopher J.; Kan, Peter; Kalousek, Vladimir; Lylyk, Pedro; Boddu, Srikanth; Knopman, Jared; Tjoumakaris, Stavropoula I.; Cuellar-Saenz, Hugo H.; Jabbour, Pascal M.; Clarençon, Frédéric; Limbucci, Nicola; Pereira, Vitor Mendes; Patel, Aman B.; Altschul, David J; Dmytriw, Adam A.; and WorldWideWEB Consortium Collaborators, "Factors Influencing Immediate Post-Angiographic Occlusion Outcomes in Intracranial Aneurysms Treated With the Woven EndoBridge Device: A Multi-Center Analysis and Predictive Model From the WorldWideWEB Consortium" (2025). Jefferson Hospital Staff Papers and Presentations. Paper 69.
https://jdc.jefferson.edu/tjuhpapers/69
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
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Language
English
Comments
This article is the author's final published version in Neurosurgical Review, Volume 49, 2026, Article number 36.
The published version is available at https://doi.org/10.1007/s10143-025-03928-w. Copyright © The Author(s) 2025.