Universität zu Köln

Kabbasch, Christoph, Goertz, Lukas, Siebert, Eberhard, Herzberg, Moriz, Borggrefe, Jan ORCID: 0000-0003-2908-7560, Krischek, Boris, Stavrinou, Pantelis, Dorn, Franziska ORCID: 0000-0001-9093-8307 and Liebig, Thomas (2019). WEB embolization versus stent-assisted coiling: comparison of complication rates and angiographic outcomes. J. NeuroInterventional Surg., 11 (8). S. 812 - 818. LONDON: BMJ PUBLISHING GROUP. ISSN 1759-8486

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Abstract

Background Intrasaccular flow disruption represents a new paradigm in endovascular treatment of wide-necked bifurcation aneurysms. Objective To perform a matched case-control study comparing complications and angiographic outcome using the Woven Endobridge (WEB) device and stent-assisted coiling (SAC). Methods Sixty-six patients treated with the WEB at three German tertiary care centers were included and matched with 66 patients treated with SAC based on aneurysm location and unruptured/ruptured aneurysm status. Parameters were retrospectively analysed and compared between the treatment groups using inverse probability of treatment weighting (IPTW) with propensity scores. Results Procedural complication rates were 12.1% in the WEB group and 21.2% in the SAC group, which was statistically significant after IPTW adjustment (OR=2.2, 95% CI 1.08 to 4.4, p=0.03). Favourable outcome (modified Rankin scale score <= 2) was achieved by 57/66 (86.4%) in the WEB group and 57/66 (86.4%) in the SAC group (p=1.0). At mid-term follow-up, a similar number of aneurysms achieved adequate occlusion (complete occlusion or neck remnant) in the WEB group (93.9%) and in the SAC group (93.9%, p=1.0). Re-treatment was performed in 10.6% after WEB embolization and 12.1% after SAC (p=1.0). Conclusions The WEB provides similar mid-term aneurysm occlusion rates to those of SAC, with no additional morbidity and potentially lower complication rates. Long-term outcome analysis will provide a definite conclusion on the use of WEB for intracranial aneurysms.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebert, Eberhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Herzberg, Moriz UNSPECIFIED UNSPECIFIED UNSPECIFIED Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED Krischek, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Stavrinou, Pantelis UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, Franziska UNSPECIFIED orcid.org/0000-0001-9093-8307 UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-145237
DOI:	10.1136/neurintsurg-2018-014555
Journal or Publication Title:	J. NeuroInterventional Surg.
Volume:	11
Number:	8
Page Range:	S. 812 - 818
Date:	2019
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1759-8486
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language UNRUPTURED INTRACRANIAL ANEURYSMS; DUAL ANTIPLATELET THERAPY; CEREBRAL ANEURYSMS; SAFETY; RISK Multiple languages Neuroimaging; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14523