• Marie Teresa Nawka, Jens Fiehler, Maxim Bester, and Gabriel Broocks.
• Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
• Neurosurgery. 2022 May 1; 90 (5): 597-604.

BackgroundWoven EndoBridge (WEB) shape modification (WSM) is a frequently observed phenomenon after aneurysm embolization.ObjectiveTo test our hypothesis that WSM is associated with worse aneurysm occlusion on short-term angiographic follow-up images.MethodsPatients with short-term follow-up digital subtraction angiography (DSA) available were included. Baseline patient characteristics, aneurysm morphometrics, and WEB dimensions ("conventional" parameters) and height and width WSM ("WSM" parameters) in the initial and the follow-up examination were analyzed. For ordinal regression analyses, aneurysm occlusion was graded according to the Bicêtre Occlusion Scale Score (BOSS; grades 0, 0', 1, 2, 3, and 1 + 3). Receiver operating characteristic curve analysis was used to distinguish adequately (BOSS 0, 0', and 1) from incompletely (BOSS 2, 3, and 1 + 3) occluded aneurysms.ResultsWe included 93 patients with 96 aneurysms. Adequate occlusion was observed in 72 cases (75.0%). In univariate ordinal regression analysis, width WSM in anteroposterior DSA (odds ratio = 0.96, 95% CI: 0.94-0.99, P = .010) and in lateral DSA (odds ratio = 0.98, 95% CI: 0.97-0.99, P = .049) were significantly associated with the BOSS after 6 months. In multivariate regression analysis, WSM was not independently associated with aneurysm occlusion. Based on receiver operating characteristic curve analysis, the area under the curve (AUC) of the "conventional" model (AUC = 0.83, 95% CI 0.74-0.90) was higher than the AUC of the "WSM" model (WSM; AUC = 0.70, 95% CI 0.60-0.79).ConclusionWSM was not independently associated with angiographic aneurysm occlusion status after 6 months. However, the "conventional" parameters including sex, rupture state, WEB type, WEB width, aneurysm width, height, and volume were associated with partial aneurysm recanalization in WEB-treated patients at the short-term follow-up.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

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