Predictive modeling of long-term improvement in occlusion outcomes following Woven EndoBridge treatment of cerebral aneurysms: A machine learning approach

Alireza Karandish; Muhammed Amir Essibayi; Mohamed Sobhi Jabal; Hamza Adel Salim; Basel Musmar; Nimer Adeeb; Mahmoud Dibas; Davide Simonato; Yan-Lin Li; James Grist; Fulvio Zaccagna; Oktay Algin; Sherief Ghozy; Sovann V Lay; Adrien Guenego; Leonardo Renieri; Joseph Carnevale; Guillaume Saliou; Panagiotis Mastorakos; Kareem El Naamani; Eimad Shotar; Markus Möhlenbruch; Michael Kral; Charlotte Chung; Mohamed M Salem; Ivan Lylyk; Paul M Foreman; Hamza Shaikh; Vedran Župančić; Muhammad U Hafeez; Joshua Catapano; Muhammad Waqas; Atilla Kazanci; Giyas Ayberk; James D Rabinov; Julian Maingard; 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; Bryan Pukenas; Jan-Karl Burkhardt; Thien Huynh; Juan Carlos Martinez-Gutierrez; Sunil A Sheth; Diana Slawski; Rabih Tawk; Benjamin Pulli; Boris Lubicz; Pietro Panni; Ajit S Puri; Guglielmo Pero; Eytan Raz; Christoph J Griessenauer; Hamed Asadi; Adnan Siddiqui; Elad I Levy; Neil Haranhalli; Andrew F Ducruet; Felipe C Albuquerque; Robert W Regenhardt; Christopher J Stapleton; Peter Kan; Vladimir Kalousek; Pedro Lylyk; Srikanth Boddu; Jared Knopman; Stavropoula I Tjoumakaris; Hugo H Cuellar-Saenz; Pascal M Jabbour; Frédéric Clarençon; Nicola Limbucci; Aman B Patel; Maurizio Fuschi; David Altschul; Adam A Dmytriw; WorldWideWEB Investigators

doi:10.1177/15910199251391915

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Predictive modeling of long-term improvement in occlusion outcomes following Woven EndoBridge treatment of cerebral aneurysms: A machine learning approach

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Predictive modeling of long-term improvement in occlusion outcomes following Woven EndoBridge treatment of cerebral aneurysms: A machine learning approach

Alireza Karandish, Muhammed Amir Essibayi, Mohamed Sobhi Jabal, Hamza Adel Salim, Basel Musmar, Nimer Adeeb, Mahmoud Dibas, Davide Simonato, Yan-Lin Li, James Grist, …

Interventional neuroradiology, p.15910199251391915

2025-11-03

DOI: https://doi.org/10.1177/15910199251391915

PMID: 41182964

Appears in Miller School of Medicine - Latest Publications

Abstract

endovascular

Woven EndoBridge (WEB)

intracranial aneurysm

machine learning

BackgroundThe Woven EndoBridge (WEB) device represents an innovative solution for cerebral aneurysm occlusion, particularly for challenging wide-neck bifurcation aneurysms. However, factors affecting sustained occlusion remain poorly understood. We utilized machine learning to attempt to identify predictors of favorable long-term outcomes following WEB treatment.MethodsIn this multicenter retrospective study, we collected patient demographics, aneurysm characteristics, procedural details, and clinical outcomes. The primary endpoint was improvement in occlusion status, defined as maintained Raymond-Roy Occlusion Classification (RROC) grade 1, or improvement from grade 2 to 1, or from grade 3 to either 2 or 1 on final angiographic follow up. The dataset was split into training (75%) and validation (25%) sets. The CatBoost algorithm was selected based on performance metrics, with Shapley Additive exPlanations (SHAP) values calculated to determine feature importance. Furthermore, a multivariable binomial logistic regression model was performed to validate machine learning findings.ResultsAmong 720 aneurysms from 36 hospitals, 84% showed improvement in occlusion at follow up. Both machine learning and multivariable logistic regression identified aneurysm height as the most consistent correlate of nonimprovement (odds ratio (OR) 0.90 per mm, p = 0.022). In the CatBoost model, the highest-ranking features by SHAP included aneurysm height, patient age, treatment acuity, ACom location, WEB-SLS device, bifurcation anatomy, aneurysm multiplicity, baseline modified Rankin Scale, access route, and partial thrombosis.ConclusionsMachine-learning and regression analyses identified consistent predictors of occlusion improvement after WEB treatment, with aneurysm height most strongly linked to nonimprovement. These insights may guide patient selection and follow up. Findings require cautious interpretation and external validation in larger cohorts.

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Title: Predictive modeling of long-term improvement in occlusion outcomes following Woven EndoBridge treatment of cerebral aneurysms: A machine learning approach
Creators: Alireza Karandish - Albert Einstein College of Medicine
Muhammed Amir Essibayi - Albert Einstein College of Medicine
Mohamed Sobhi Jabal - Mayo Clinic in Arizona
Hamza Adel Salim - Johns Hopkins Bayview Medical Center
Basel Musmar - Louisiana State University in Shreveport
Nimer Adeeb - Louisiana State University in Shreveport
Mahmoud Dibas - Louisiana State University in Shreveport
Davide Simonato - Oxford University Hospitals NHS Trust
Yan-Lin Li - Oxford University Hospitals NHS Trust
James Grist - Oxford University Hospitals NHS Trust
Fulvio Zaccagna - Oxford University Hospitals NHS Trust
Oktay Algin - Ankara University
Sherief Ghozy - Mayo Clinic in Arizona
Sovann V Lay - Centre Hospitalier Universitaire de Toulouse
Adrien Guenego - Hôpital Universitaire Dupuytren
Leonardo Renieri - Department of Neuroradiology, Ospedale Careggi di Firenze, Florence, Italy
Joseph Carnevale - Presbyterian Hospital
Guillaume Saliou - University Hospital of Lausanne
Panagiotis Mastorakos - Thomas Jefferson University Hospital
Kareem El Naamani - Thomas Jefferson University Hospital
Eimad Shotar - Pitié-Salpêtrière Hospital
Markus Möhlenbruch - Heidelberg University
Michael Kral - Christian Doppler Klinik
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
Hamza Shaikh - Sisters of Mercy Health System
Vedran Župančić - Baylor School
Muhammad U Hafeez - Barrow Neurological Institute
Joshua Catapano - University at Buffalo, State University of New York
Muhammad Waqas - University at Buffalo, State University of New York
Atilla Kazanci - Ankara Yıldırım Beyazıt University
Giyas Ayberk - Ankara Yıldırım Beyazıt University
James D Rabinov - Harvard University
Julian Maingard - Austin Health
Clemens M Schirmer - Geisinger Medical Center
Mariangela Piano - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Anna L Kühn - Memorial Hospital
Caterina Michelozzi - IRCCS Ospedale San Raffaele
Robert M Starke - University of Miami
Ameer Hassan - Valley Baptist Medical Center
Mark Ogilvie - University of Alabama at Birmingham
Anh Nguyen - University Hospital of Basel
Jesse Jones - University of Alabama at Birmingham
Waleed Brinjikji - Mayo Clinic in Arizona
Marie T Nawka - University Medical Center Hamburg-Eppendorf
Marios Psychogios - University Hospital of Basel
Christian Ulfert - Heidelberg University
Bryan Pukenas - University of Pennsylvania
Jan-Karl Burkhardt - University of Pennsylvania
Thien Huynh - Mayo Clinic in Florida
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
Diana Slawski - Stanford University
Rabih Tawk - Mayo Clinic in Florida
Benjamin Pulli - Stanford University
Boris Lubicz - Hôpital Universitaire Dupuytren
Pietro Panni - IRCCS Ospedale San Raffaele
Ajit S Puri - Memorial Hospital
Guglielmo Pero - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Eytan Raz - NYU Langone Health
Christoph J Griessenauer - Christian Doppler Klinik
Hamed Asadi - NYU Langone Health
Adnan Siddiqui - University at Buffalo, State University of New York
Elad I Levy - University at Buffalo, State University of New York
Neil Haranhalli - Albert Einstein College of Medicine
Andrew F Ducruet - Barrow Neurological Institute
Felipe C Albuquerque - Barrow Neurological Institute
Robert W Regenhardt - Harvard University
Christopher J Stapleton - Harvard University
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 - NewYork–Presbyterian Hospital
Jared Knopman - University Hospital of Lausanne
Stavropoula I Tjoumakaris - Thomas Jefferson University Hospital
Hugo H Cuellar-Saenz - Louisiana State University
Pascal M Jabbour - Thomas Jefferson University Hospital
Frédéric Clarençon - Pitié-Salpêtrière Hospital
Nicola Limbucci - Cornell University
Aman B Patel - Harvard University
Maurizio Fuschi - Oxford University Hospitals NHS Trust
David Altschul - Albert Einstein College of Medicine
Adam A Dmytriw - St. Michael's Hospital
WorldWideWEB Investigators
Publication Details: Interventional neuroradiology, p.15910199251391915
Publisher: SAGE PUBLICATIONS INC; THOUSAND OAKS
Number of pages: 9
Academic Unit: UMMG Dept of Neurological Surgery; Miller School of Medicine
Language: English
Resource Type: Journal article
PMID: 41182964
Record Identifier: 991032854732002976