Off-Label Use of Woven EndoBridge Device for Intracranial Brain Aneurysm Treatment: Modeling of Occlusion Outcome

Muhammed Amir Essibayi; Mohamed Sobhi Jabal; Basel Musmar; Nimer Adeeb; Hamza Salim; Assala Aslan; Nicole M. Cancelliere; Rachel M. McLellan; Oktay Algin; Sherief Ghozy; Sovann V. Lay; Adrien Guenego; Leonardo Renieri; Joseph Carnevale; Guillaume Saliou; Panagiotis Mastorakos; Kareem El Naamani; Eimad Shotar; Kevin Premat; Markus Möhlenbruch; Michael Kral; Omer Doron; Charlotte Chung; Mohamed M Salem; Ivan Lylyk; Paul M. Foreman; Jay A. Vachhani; Hamza Shaikh; Vedran Župančić; Muhammad U. Hafeez; Joshua Catapano; Muhammad Waqas; Kivilcim Yavuz; Yasin Celal Gunes; James D. Rabinov; Yifan Ren; Clemens M. Schirmer; Mariangela Piano; Anna L. Kühn; Caterina Michelozzi; Robert M. Starke; Ameer Hassan; Mark Ogilvie; Anh Nguyen; Jesse Jones; Waleed Brinjikji; Marie T. Nawka; Marios Psychogios; Christian Ulfert; Jose Danilo Bengzon Diestro; Bryan Pukenas; Jan-Karl Burkhardt; Thien Huynh; Juan Carlos Martinez Gutierrez; Sunil A. Sheth; Gary Spiegel; Rabih Tawk; Boris Lubicz; Pietro Panni; Ajit S. Puri; Guglielmo Pero; Erez Nossek; Eytan Raz; Monika Killer-Oberfalzer; Christoph J. Griessenauer; Hamed Asadi; Adnan Siddiqui; Allan L. Brook; Neil Haranhalli; Andrew F. Ducruet; Felipe C. Albuquerque; Robert W. Regenhardt; Christopher J. Stapleton; Peter Kan; Vladimir Kalousek; Pedro Lylyk; Srikanth Boddu; Jared Knopman; Mohammad A. Aziz-Sultan; Stavropoula I. Tjoumakaris; Frédéric Clarençon; Nicola Limbucci; Hugo H. Cuellar-Saenz; Pascal M Jabbour; Vitor Mendes Pereira; Aman B. Patel; David Altschul; Adam A. Dmytriw; Mahmoud Dibas; Julian Spears; Sri Hari Sundararajan; Alii Al Balush; Justin E. Vranic; Yasuaki Inoue; Shervin Mirshahi; Naif Alotaibi; Pablo Harker; Vincent M. Tutino; Peter Sporns; Alex Brehm; WorldWideWEB Consortium

doi:10.1016/j.jstrokecerebrovasdis.2024.107897

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Off-Label Use of Woven EndoBridge Device for Intracranial Brain Aneurysm Treatment: Modeling of Occlusion Outcome

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Peer reviewed

Off-Label Use of Woven EndoBridge Device for Intracranial Brain Aneurysm Treatment: Modeling of Occlusion Outcome

Muhammed Amir Essibayi, Mohamed Sobhi Jabal, Basel Musmar, Nimer Adeeb, Hamza Salim, Assala Aslan, Nicole M. Cancelliere, Rachel M. McLellan, Oktay Algin, Sherief Ghozy, …

Journal of stroke and cerebrovascular diseases, p.107897

2024-07-26

DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.107897

Appears in Miller School of Medicine - Latest Publications

Abstract

aneurysms

intracranial

WEB

Woven EndoBridge, off-label

The Woven EndoBridge (WEB) device is emerging as a novel therapy for intracranial aneurysms, but its use for off-label indications requires further study. Using machine learning, we aimed to develop predictive models for complete occlusion after off-label WEB treatment and to identify factors associated with occlusion outcomes. This multicenter, retrospective study included 162 patients who underwent off-label WEB treatment for intracranial aneurysms. Baseline, morphological, and procedural variables were utilized to develop machine-learning models predicting complete occlusion. Model interpretation was performed to determine significant predictors. Ordinal regression was also performed with occlusion status as an ordinal outcome from better (Raymond Roy Occlusion Classification [RROC] grade 1) to worse (RROC grade 3) status. Odds ratios (OR) with 95% confidence intervals (CI) were reported. The best performing model achieved an AUROC of 0.8 for predicting complete occlusion. Larger neck diameter and daughter sac were significant independent predictors of incomplete occlusion. On multivariable ordinal regression, higher RROC grades (OR 1.86, 95% CI 1.25-2.82), larger neck diameter (OR 1.69, 95% CI 1.09-2.65), and presence of daughter sacs (OR 2.26, 95% CI 0.99-5.15) were associated with worse aneurysm occlusion after WEB treatment, independent of other factors. This study found that larger neck diameter and daughter sacs were associated with worse occlusion after WEB therapy for aneurysms. The machine learning approach identified anatomical factors related to occlusion outcomes that may help guide patient selection and monitoring with this technology. Further validation is needed.

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Title: Off-Label Use of Woven EndoBridge Device for Intracranial Brain Aneurysm Treatment: Modeling of Occlusion Outcome
Creators: Muhammed Amir Essibayi - Albert Einstein College of Medicine
Mohamed Sobhi Jabal - Mayo Clinic
Basel Musmar - Louisiana State University
Nimer Adeeb - Louisiana State University
Hamza Salim - Louisiana State University
Assala Aslan - Louisiana State University
Nicole M. Cancelliere - St. Michael's Hospital
Rachel M. McLellan - Brigham and Women's Hospital
Oktay Algin - Ankara University
Sherief Ghozy - Mayo Clinic
Sovann V. Lay - Department of Neuroradiology, Centre Hospitalier de Toulouse, Toulouse, France
Adrien Guenego - Department of Neuroradiology, Hôpital Universitaire Erasme, Bruxelles, Belgium
Leonardo Renieri - Florence
Joseph Carnevale - Presbyterian Hospital
Guillaume Saliou - Department of Neuroradiology, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland
Panagiotis Mastorakos - Thomas Jefferson University Hospital
Kareem El Naamani - Thomas Jefferson University Hospital
Eimad Shotar - Department of Neuroradiology, Hôpital Pitié-Salpêtrière, Paris, France
Kevin Premat - Department of Neuroradiology, Hôpital Pitié-Salpêtrière, Paris, France
Markus Möhlenbruch - Heidelberg
Michael Kral - Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria
Omer Doron - Brigham and Women's Hospital
Charlotte Chung - NYU Langone Health
Mohamed M Salem - University of Pennsylvania
Ivan Lylyk - Department of Neuroradiology, Clínica La Sagrada Familia, Buenos Aires, Argentina
Paul M. Foreman - Orlando Health
Jay A. Vachhani - Orlando Health
Hamza Shaikh - Cooper University Health Care
Vedran Župančić - Sisters of Mercy Health System
Muhammad U. Hafeez - Baylor School
Joshua Catapano - Barrow Neurological Institute
Muhammad Waqas - Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA
Kivilcim Yavuz - Ankara University
Yasin Celal Gunes - Ankara University
James D. Rabinov - Brigham and Women's Hospital
Yifan Ren - Austin Health
Clemens M. Schirmer - Department of Neurosurgery and Radiology, Geisinger Hospital, Danville, PA, USA
Mariangela Piano - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Anna L. Kühn - Department of Neuroradiology, UMass Memorial Hospital, Worcester, MA, USA
Caterina Michelozzi - IRCCS Ospedale San Raffaele
Robert M. Starke - University of Miami
Ameer Hassan - Neuroscience Institute
Mark Ogilvie - University of Alabama at Birmingham
Anh Nguyen - University Hospital of Basel
Jesse Jones - University of Alabama at Birmingham
Waleed Brinjikji - Mayo Clinic
Marie T. Nawka - University Medical Center Hamburg-Eppendorf
Marios Psychogios - University Hospital of Basel
Christian Ulfert - Heidelberg
Jose Danilo Bengzon Diestro - St. Michael's Hospital
Bryan Pukenas - University of Pennsylvania
Jan-Karl Burkhardt - University of Pennsylvania
Thien Huynh - Mayo Clinic
Juan Carlos Martinez Gutierrez - The University of Texas Health Science Center at Houston
Sunil A. Sheth - The University of Texas Health Science Center at Houston
Gary Spiegel - The University of Texas Health Science Center at Houston
Rabih Tawk - Mayo Clinic
Boris Lubicz - Department of Neuroradiology, Hôpital Universitaire Erasme, Bruxelles, Belgium
Pietro Panni - IRCCS Ospedale San Raffaele
Ajit S. Puri - Department of Neuroradiology, UMass Memorial Hospital, Worcester, MA, USA
Guglielmo Pero - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Erez Nossek - NYU Langone Health
Eytan Raz - NYU Langone Health
Monika Killer-Oberfalzer - Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria
Christoph J. Griessenauer - Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Salzburg, Austria
Hamed Asadi - Austin Health
Adnan Siddiqui - Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA
Allan L. Brook - Albert Einstein College of Medicine
Neil Haranhalli - Albert Einstein College of Medicine
Andrew F. Ducruet - Barrow Neurological Institute
Felipe C. Albuquerque - Barrow Neurological Institute
Robert W. Regenhardt - Brigham and Women's Hospital
Christopher J. Stapleton - Brigham and Women's Hospital
Peter Kan - Baylor School
Vladimir Kalousek - Sisters of Mercy Health System
Pedro Lylyk - Department of Neuroradiology, Clínica La Sagrada Familia, Buenos Aires, Argentina
Srikanth Boddu - Department of Neuroradiology, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland
Jared Knopman - Synod Hospital
Mohammad A. Aziz-Sultan - Brigham and Women's Hospital
Stavropoula I. Tjoumakaris - Thomas Jefferson University Hospital
Frédéric Clarençon - Department of Neuroradiology, Hôpital Pitié-Salpêtrière, Paris, France
Nicola Limbucci - Florence
Hugo H. Cuellar-Saenz - Louisiana State University
Pascal M Jabbour - Thomas Jefferson University Hospital
Vitor Mendes Pereira - Brigham and Women's Hospital
Aman B. Patel - Brigham and Women's Hospital
David Altschul - Albert Einstein College of Medicine
Adam A. Dmytriw - Louisiana State University
Mahmoud Dibas - Albert Einstein College of Medicine
Julian Spears - Mayo Clinic
Sri Hari Sundararajan - Florence
Alii Al Balush - Florence
Justin E. Vranic - Louisiana State University
Yasuaki Inoue - Louisiana State University
Shervin Mirshahi - Louisiana State University
Naif Alotaibi - Louisiana State University
Pablo Harker - Louisiana State University
Vincent M. Tutino - Barrow Neurological Institute
Peter Sporns - University of Alabama at Birmingham
Alex Brehm - Louisiana State University
WorldWideWEB Consortium
Publication Details: Journal of stroke and cerebrovascular diseases, p.107897
Publisher: Elsevier Inc
Academic Unit: UMMG Dept of Neurological Surgery; Miller School of Medicine
Language: English
Resource Type: Journal article
Record Identifier: 991032079354702976