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Publications

Journal Article Ahead of print

PubMed: 42235803 DOI: 10.1016/j.jstrokecerebrovasdis.2026.108669

Early Angiographic Recurrence After Woven EndoBridge Treatment of Anterior Circulation Aneurysms: Development of a Pilot Nomogram.

J Stroke Cerebrovasc Dis

Authors: Yasar Unsal, Mehmet Ozgur Ozates, Yunus Emre Karatas, Kadır Cetinkaya, Oktay Algin, Atılla Kazanci, Gıyas Ayberk

Affiliations

  • Neurosurgery Department, Ankara Bilkent City Hospital, Turkey, Ankara.
  • Neurosurgery Department, Ankara Yıldırım Beyazıt University, Turkey, Ankara.
  • Directorate of Administrative and Financial Affairs, Ankara University, Turkey, Ankara.
  • Hittite University Çorum Erol Olçok Education and Research Hospital,Turkey, Corum.
  • The Interventional MRI Clinical R&D Institute (GİMRE), Ankara University, Turkey, Ankara.

Abstract

BACKGROUND

Early inadequate occlusion after Woven EndoBridge (WEB) treatment remains a clinically relevant issue, and reliable imaging-based predictors of early failure are limited. We aimed to identify clinical and morphological factors associated with early inadequate occlusion in anterior circulation aneurysms treated with WEB and to develop an exploratory pilot predictive model for individualized risk estimation.

METHODS

Seventy-three consecutive patients with anterior circulation aneurysms treated with the WEB device between 2021 and 2023 were retrospectively analyzed. Demographic and clinical variables, as well as aneurysm diameter, height, and neck width, were recorded. Early inadequate occlusion was defined as suboptimal angiographic outcome (WOS C/D) on 6-month follow-up angiography. Univariable analyses were performed, followed by multivariable logistic regression to construct an exploratory predictive model. Model performance was assessed using discrimination, calibration, decision curve analysis, and internal bootstrap validation.

RESULTS

Early inadequate occlusion occurred in 17 patients (24.6%). Larger aneurysm diameter and height were associated with failure in univariable analyses. In multivariable analysis, no single morphological parameter independently predicted inadequate occlusion; however, baseline neck width showed an inverse association with early failure. The model demonstrated good discrimination (C-index 0.80), acceptable calibration after bootstrap correction, and potential clinical utility across a range of threshold probabilities.

CONCLUSIONS

This exploratory predictive model serves as a hypothesis-generating tool for early risk stratification following WEB treatment. The inverse association between neck width and inadequate occlusion highlights the complexity of aneurysm-device interaction and warrants further validation in larger, independent cohorts.

MeSH

Pilots, Nomograms, Aneurysm, Cerebrovascular Disorders, Therapeutics