Universität zu Köln

Pennig, Lenhard, Goertz, Lukas, Hoyer, Ulrike Cornelia Isabel, Dorn, Franziska, Siebert, Eberhard, Herzberg, Moriz, Borggrefe, Jan ORCID: 0000-0003-2908-7560, Schlamann, Marc, Liebig, Thomas and Kabbasch, Christoph ORCID: 0000-0003-3712-2258 (2021). The Woven EndoBridge (WEB) Versus Conventional Coiling for Treatment of Patients with Aneurysmal Subarachnoid Hemorrhage: Propensity Score-Matched Analysis of Clinical and Angiographic Outcome Data. World Neurosurg., 146. S. E1326 - 9. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

OBJECTIVE: Conventional coiling is standard for treatment of ruptured intracranial aneurysms. We compared clinical and angiographic outcomes between intrasaccular flow disruption with the Woven EndoBridge (WEB) and conventional coiling in patients with aneurysmal sub-arachnoid hemorrhage (aSAH) using a propensity score-matched analysis. METHODS: This is a retrospective study of consecutive patients with aSAH treated with the WEB or conventional coiling between 2010 and 2019. Baseline characteristics, procedural complications, angiographic results, and functional outcome were compared between both groups. RESULTS: Fifty-two patients treated with the WEB and 236 patients treated by coiling were included. The WEB group was characterized by a higher patient age (P = 0.024), a wider aneurysm neck (P < 0.001), and more frequent location at the posterior circulation (P = 0.004). Procedural complications were comparable between WEB (19.2%) and coiling (22.7%, P = 0.447). In-hospital mortality rates were higher in the coiling group (WEB: 5.8%, coiling: 17.8%; P = 0.0034). Favorable outcome (modified Rankin scale <= 2) was obtained in 51.3% after WEB embolization and in 55.0% after coiling (P = 0.653). Retreatment was performed in 26.4% of patients after WEB and in 25.8% after coiling (P = 0.935). Propensity score analysis confirmed these results and revealed higher adequate occlusion rates at midterm follow-up for WEB-treated aneurysms (WEB: 93.9%, coiling: 76.2%, P = 0.058). CONCLUSIONS: Compared with conventional coiling, aSAH patients treated with the WEB have a similar clinical and potentially improved angiographic outcome at midterm follow- up. The WEB might be considered as an alternative to conventional coiling for the treatment of RIAs, in particular for those with wide-necked and thus challenging anatomy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pennig, Lenhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoyer, Ulrike Cornelia Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebert, Eberhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Herzberg, Moriz UNSPECIFIED UNSPECIFIED UNSPECIFIED Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED Schlamann, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED orcid.org/0000-0003-3712-2258 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-590494
DOI:	10.1016/j.wneu.2020.11.158
Journal or Publication Title:	World Neurosurg.
Volume:	146
Page Range:	S. E1326 - 9
Date:	2021
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 RUPTURED INTRACRANIAL ANEURYSMS; STENT-ASSISTED COILING; ENDOVASCULAR TREATMENT; UNRUPTURED ANEURYSMS; CEREBRAL ANEURYSMS; EMBOLIZATION; DEVICE; SAFETY; RECURRENCE; EXPERIENCE Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59049