Purpose: To identify factors influencing short- and mid-term radiological outcomes of intracranial aneurysms (IAs) treated with the Woven EndoBridge (WEB).
Methods: A total of 112 patients were treated for IAs with the WEB in at our institution between 2013 and 2020. Patients with 6- and/or 24-months follow-up data were included in the study. Aneurysm occlusion was evaluated using the Raymond-Roy occlusion classification (RR). RR 1 and RR 2 were considered as adequate outcomes, while RR 3 inadequate.
Results: Data were available for 91 patients (56 females, 62%) at 6 months and 62 of those patients (39 females, 58%) at 24 months. The adequate occlusion (RR 1/RR 2) rate was 89% ( = 81/91) at the 6-months follow-up and 91% ( = 56/62) at the 24-months follow-up. The treatment-related morbidity rate was 4% ( = 4/91), and mortality rate was 1% ( = 1/91). The predictor for inadequate occlusion at the 6-months follow-up was the lobular shape of an aneurysm ( = .01). The aneurysm's height ( = .02), maximal diameter ( = .001), width ( = .002), aspect ratio ( = .03), dome-to-neck ratio ( = .04), and lobular shape (= .03) were predictive factors for inadequate occlusion at 24 months. All the thrombosed aneurysms ( = 3) showed unfavorable radiological outcomes and required re-treatment within 24 months. None of the patient-related factors were significant.
Conclusions: The WEB provides favorable occlusion rates and low complications for both ruptured and unruptured wide-necked IAs. Unfavorable radiological outcomes after WEB treatment may be related to aneurysm morphology and size.
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http://dx.doi.org/10.1177/19714009221122216 | DOI Listing |
Oper Neurosurg (Hagerstown)
November 2024
Department of Neurosurgery, University of Pennsylvania Health System, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
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January 2025
From the Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
Endosaccular flow disruption has emerged as a transformative approach for treating wide-neck intracranial aneurysms, which are characterized by neck diameters exceeding 4 millimeters or dome-to-neck ratios below 2. This review examines the technical specifications and clinical outcomes of major endosaccular devices, including the Woven EndoBridge (WEB) device, the Artisse embolization device, the Medina embolization device, the neck bridging device for bifurcation aneurysms, the polycarbonate urethane membrane-assisted device, the Galaxy saccular endovascular aneurysm lattice, and the Contour Neurovascular System. Analysis of pivotal trials reveals varying degrees of efficacy and safety across platforms.
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Olympia Hospital & Research Centre, Trichy, Tamilnadu, India.
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From the Department of Radiology (S.Q., R.C., J.C.C., M.M., B.D.A., R.A.) and the Division of Cardiology, Department of Medicine (V.A., J.E.W., R.L.W., D.C.L.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago, IL 60611; Prince Charles Hospital, Chermside, Queensland, Australia (V.A.); and the Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, Ill (M.M.).
Orthotopic heart transplant (OHT) is a well-established therapy for end-stage heart failure that leads to improved long-term survival rates, with careful allograft surveillance essential for optimizing clinical outcomes after OHT. Unfortunately, complications can arise after OHT that can compromise the success of the OHT. Cardiac MRI is continually evolving, with a range of advanced techniques that can be applied to evaluate allograft structure and function.
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Department of Medical Specialities, Pulmonology Unit, GB Morgagni-L. Pierantoni Hospital, Forlì, Italy.
Fibrotic hypersensitivity pneumonitis (f-HP) is an interstitial lung disease in which various antigens in susceptible individuals may play a pathogenetic role. This study evaluates the role of transbronchial lung cryobiopsy (TBLC) and bronchoalveolar lavage (BAL) in identifying a UIP-like pattern and its association with fibrosis progression. We conducted a multicentre retrospective cohort study of patients diagnosed with f-HP who underwent BAL and TBLC between 2011 and 2023.
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