Universität zu Köln

Goertz, Lukas, Liebig, Thomas, Siebert, Eberhard ORCID: 0000-0001-7395-6546, Pennig, Lenhard, Laukamp, Kai Roman, Celik, Erkan, Timmer, Marco, Brinker, Gerrit, Schlamann, Marc, Goldbrunner, Roland, Dorn, Franziska, Krischek, Boris and Kabbasch, Christoph (2021). Woven Endobridge Embolization Versus Microsurgical Clipping for Unruptured Anterior Circulation Aneurysms: A Propensity Score Analysis. Neurosurgery, 88 (4). S. 779 - 785. CARY: OXFORD UNIV PRESS INC. ISSN 1524-4040

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Abstract

BACKGROUND: Intrasaccular flow-disruption represents a new paradigmin endovascular treatment of wide-necked bifurcation aneurysms. OBJECTIVE: To retrospectively compare Woven Endobridge ( WEB) embolization with microsurgical clipping for unruptured anterior circulation aneurysms using propensity score adjustment. METHODS: A total of 63 patients treated with WEB and 103 patients treated with clipping were compared based on the intention-to-treat principle. The primary outcome measures were immediate technical treatment success, major adverse events, and 6-mo complete aneurysm occlusion. RESULTS: The technical success rates were 83% for WEB and 100% for clipping. Procedu-rerelated complications occurred more often in the clipping group (13%) than the WEB group (6%, adjusted P < .01). However, the rates of major adverse events were comparable in both groups (WEB: 3%, clip: 4%, adjusted P = .53). At the 6-mo follow-up, favorable functional outcomes were achieved in 98% of the WEB embolization group and 99% of the clipping group (adjusted P = .19). Six-month complete aneurysmocclusion was obtained in 75% of the WEB group and 94% of the clipping group (adjusted P < .01). CONCLUSION: Microsurgical clipping was associated with higher technical success and complete occlusion rates, whereas WEB had a lower complication rate. Favorable functional outcomes were achieved in >= 98% of both groups. The decision to use a specific treatment modality should be made on an individual basis and in accordance with the patient's preferences.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebert, Eberhard UNSPECIFIED orcid.org/0000-0001-7395-6546 UNSPECIFIED Pennig, Lenhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Laukamp, Kai Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Celik, Erkan UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmer, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinker, Gerrit UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlamann, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Krischek, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-590143
DOI:	10.1093/neuros/nyaa539
Journal or Publication Title:	Neurosurgery
Volume:	88
Number:	4
Page Range:	S. 779 - 785
Date:	2021
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1524-4040
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTRACRANIAL ANEURYSMS Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59014