Background <p>The Woven EndoBridge (WEB) device is an effective treatment for wide-neck aneurysms (WNA). This study aims to identify and compare anatomical and procedural factors that predicts the aneurysm occlusion, both adequate and inadequate after WEB device treatment.</p> Methods <p>A systematic review and meta-analysis were conducted using PubMed, Embase, Scopus, and Web of Science, including studies up to October 25, 2024. Data on angiographic outcomes of WEB occlusion were extracted and analyzed using R version 4.4.2.</p> Results <p>Nine studies (790 patients) were included. Female patients were 1.64 times more likely to achieve adequate occlusion than males (OR: 1.64, 95% CI: [1.06, 2.52], <i>P</i> = 0.026). Regular-shaped aneurysms had a 2.44-fold higher likelihood of adequate occlusion compared to irregular ones (OR: 0.41, 95% CI: [0.23, 0.74], <i>P</i> = 0.003). Aneurysm neck size was significantly smaller in the adequate occlusion group (3.9&#xa0;mm vs. 4.4&#xa0;mm, MD: -0.48&#xa0;mm, 95% CzI: [-0.78, -0.18], <i>P</i> = 0.002). Maximum aneurysm diameter was also smaller in the adequate occlusion group (5.7&#xa0;mm vs. 6.8&#xa0;mm, MD: -1.13&#xa0;mm, 95% CI: [-1.69, -0.57], <i>P</i> &lt; 0.001). Aneurysm height was also significantly lower than the inadequate occlusion group (5.4&#xa0;mm vs. 6.3&#xa0;mm, MD: -0.92&#xa0;mm, 95% CI: [-1.55, -0.29], <i>P</i> = 0.004).</p> Conclusion <p>Smaller aneurysm dimensions, regular shape, and female sex were associated with higher adequate occlusion rates after WEB treatment. These findings may guide patient selection strategies for optimizing aneurysm occlusion. Further high-quality studies are needed to confirm these associations.</p>

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Baseline demographic and aneurysm morphologic features associated with woven endobridge angiographic outcomes: A systematic review and meta-analysis

  • Basant Lashin,
  • Sherief Ghozy,
  • Abdallah Abbas,
  • Michael Liu,
  • Abu Bakar Butt,
  • Esraa Y. Salama,
  • Milin Patel,
  • Khaled Mohamed Hamam,
  • Dina Essam Abo-elnour,
  • Jonathan Cortese,
  • Abdelrahman Hamouda,
  • Ramanathan Kadirvel,
  • David F Kallmes

摘要

Background

The Woven EndoBridge (WEB) device is an effective treatment for wide-neck aneurysms (WNA). This study aims to identify and compare anatomical and procedural factors that predicts the aneurysm occlusion, both adequate and inadequate after WEB device treatment.

Methods

A systematic review and meta-analysis were conducted using PubMed, Embase, Scopus, and Web of Science, including studies up to October 25, 2024. Data on angiographic outcomes of WEB occlusion were extracted and analyzed using R version 4.4.2.

Results

Nine studies (790 patients) were included. Female patients were 1.64 times more likely to achieve adequate occlusion than males (OR: 1.64, 95% CI: [1.06, 2.52], P = 0.026). Regular-shaped aneurysms had a 2.44-fold higher likelihood of adequate occlusion compared to irregular ones (OR: 0.41, 95% CI: [0.23, 0.74], P = 0.003). Aneurysm neck size was significantly smaller in the adequate occlusion group (3.9 mm vs. 4.4 mm, MD: -0.48 mm, 95% CzI: [-0.78, -0.18], P = 0.002). Maximum aneurysm diameter was also smaller in the adequate occlusion group (5.7 mm vs. 6.8 mm, MD: -1.13 mm, 95% CI: [-1.69, -0.57], P < 0.001). Aneurysm height was also significantly lower than the inadequate occlusion group (5.4 mm vs. 6.3 mm, MD: -0.92 mm, 95% CI: [-1.55, -0.29], P = 0.004).

Conclusion

Smaller aneurysm dimensions, regular shape, and female sex were associated with higher adequate occlusion rates after WEB treatment. These findings may guide patient selection strategies for optimizing aneurysm occlusion. Further high-quality studies are needed to confirm these associations.