Universität zu Köln

Kabbasch, Christoph ORCID: 0000-0003-3712-2258, Goertz, Lukas, Siebert, Eberhard, Herzberg, Moriz, Borggrefe, Jan ORCID: 0000-0003-2908-7560, Mpotsaris, Anastasios, Dorn, Franziska ORCID: 0000-0001-9093-8307 and Liebig, Thomas (2019). Comparison of WEB Embolization and Coiling in Unruptured Intracranial Aneurysms: Safety and Efficacy Based on a Propensity Score Analysis. World Neurosurg., 126. S. E937 - 7. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

OBJECTIVE: To compare the safety and efficacy between Woven EndoBridge (WEB) embolization and conventional coiling for treatment of unruptured intracranial aneurysms using a propensity score-matched analysis. METHODS: Consecutive patients treated with the WEB at 3 German neurovascular centers and with coiling at a single center during 2011 and 2018 were analyzed. Procedure-related complications, clinical outcome, and angiographic results were retrospectively evaluated and compared. RESULTS: Sixty-seven patients treated by coiling and 56 patients treated with the WEB were identified. Significant differences between the 2 groups were observed in patient age (P = 0.048), aneurysm location (P < 0.01), aneurysm size (P = 0.02), and neck width (P < 0.01). The overall complication rate was comparable between the coil group (9.0%) and the WEB group (8.9%, P = 1.0). Favorable outcome (modified Rankin Scale <= 2) was obtained in 98.5% after coiling and 98.2% after WEB treatment. At last available angiographic follow-up, WEB yielded a higher complete aneurysm occlusion rate (87.2%) than coiling (60.8%, P < 0.01). Nine patients in the coil cohort (17.6%) and 2 patients in the WEB cohort (4.3%) underwent retreatment (P = 0.05). After 1:1 propensity score matching, there were no significant differences in complication (P = 1.0) and morbidity rates (P = 1.0), whereas there was a trend toward a higher complete aneurysm occlusion rate after WEB treatment (P = 0.08). CONCLUSIONS: Treatment of unruptured aneurysms with the WEB provides potentially higher aneurysm occlusion rates than conventional coiling while having similar complication rates and no additional morbidity.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kabbasch, Christoph UNSPECIFIED orcid.org/0000-0003-3712-2258 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 Mpotsaris, Anastasios UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, Franziska UNSPECIFIED orcid.org/0000-0001-9093-8307 UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-146881
DOI:	10.1016/j.wneu.2019.03.016
Journal or Publication Title:	World Neurosurg.
Volume:	126
Page Range:	S. E937 - 7
Date:	2019
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-8769
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ENDOVASCULAR TREATMENT; CEREBRAL ANEURYSMS; WOVEN ENDOBRIDGE; RUPTURED ANEURYSMS; TRIAL; THERAPY; DEVICE; COHORT; SERIES; ISAT Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14688