• DiestroJose Danilo BengzonJDB1Department of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto, Ontario, Canada., Mahmoud Dibas, Nimer Adeeb, Robert W Regenhardt, Justin E Vranic, Adrien Guenego, Sovann V Lay, Leonardo Renieri, BalushiAli AlAA8Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York., Eimad Shotar, Kévin Premat, Kareem El Namaani, Guillaume Saliou, Markus A Möhlenbruch, Ivan Lylyk, Paul M Foreman, Jay A Vachhani, Vedran Župančić, Muhammad U Hafeez, Caleb Rutledge, Hamid Rai, Vincent M Tutino, Shervin Mirshahi, Sherief Ghozy, Pablo Harker, Naif M Alotaibi, James D Rabinov, Yifan Ren, Clemens M Schirmer, Oded Goren, Mariangela Piano, Anna L Kühn, Caterina Michelozzi, Stéphanie Elens, Robert M Starke, Ameer E Hassan, Arsalaan Salehani, Anh Nguyen, Jesse Jones, Marios Psychogios, Julian Spears, Thomas Marotta, Vitor Pereira, Carmen Parra-Fariñas, Maria Bres-Bullrich, Michael Mayich, Mohamed M Salem, Jan-Karl Burkhardt, Brian T Jankowitz, Ricardo A Domingo, Thien Huynh, Rabih Tawk, Christian Ulfert, Boris Lubicz, Pietro Panni, Ajit S Puri, Guglielmo Pero, Christoph J Griessenauer, Hamed Asadi, Adnan Siddiqui, Andrew F Ducruet, Felipe C Albuquerque, Nirav Patel, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Christopher J Stapleton, Jared Knopman, Pascal Jabbour, Stavropoula Tjoumakaris, Frédéric Clarençon, Nicola Limbucci, Mohammad A Aziz-Sultan, Hugo H Cuellar-Saenz, Christophe Cognard, Aman B Patel, and Adam A Dmytriw.
• 1Department of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto, Ontario, Canada.
• J. Neurosurg. 2024 Apr 1; 140 (4): 107110791071-1079.

ObjectiveThe Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for wide-necked bifurcation aneurysms. These aneurysms may require the use of a concomitant stent. The objective of this study was to determine the clinical and radiological outcomes of patients undergoing stent-assisted WEB treatment. In addition, the authors also sought to determine the predictors of a concomitant stent in aneurysms treated with the WEB device.MethodsThe data for this study were taken from the WorldWideWEB Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups based on treatment: stent-assisted WEB and WEB device alone. The authors compared clinical and radiological outcomes of both groups. Univariable and multivariable binary logistic regression analyses were performed to determine factors that predispose to stent use.ResultsThe study included 691 intracranial aneurysms (31 with stents and 660 without stents) treated with the WEB device. The adequate occlusion status did not differ between the two groups at the latest follow-up (83.3% vs 85.6%, p = 0.915). Patients who underwent stenting had more thromboembolic (32.3% vs 6.5%, p < 0.001) and procedural (16.1% vs 3.0%, p < 0.001) complications. Aneurysms treated with a concomitant stent had wider necks, greater heights, and lower dome-to-neck ratios. Increasing neck size was the only significant predictor for stent use.ConclusionsThis study demonstrates that there is no difference in the degree of aneurysm occlusion between the two groups; however, complications were more frequent in the stent group. In addition, a wider aneurysm neck predisposes to stent assistance in WEB-treated aneurysms.

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