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Shape Modification is Common in Woven EndoBridge-Treated Intracranial Aneurysms: A Longitudinal Quantitative Analysis
J Rosskopf1, M Braun2, J Dreyhaupt3
1From the Department of Radiology (J.R., M. Beer, B.L.S.) johannes.rosskopf@uni-ulm.de.
Background And Purpose:
After endovascular treatment of intracranial aneurysms with the Woven EndoBridge (WEB) device, worsening of aneurysm occlusion or re-opening was reported to be possibly associated with WEB shape modification. This study analyzed quantitatively the WEB shape modification with time in association with anatomic results.
Materials And Methods:
Thirty patients with 32 WEB-treated intracranial aneurysms fulfilled the inclusion criteria of cranial CT at baseline (day of intervention) and a follow-up CT at least >1 months' later (median follow-up time, 11.4 months; interquartile range, 6.5-21.5 months). Adequate occlusion was observed in 84.4%, and aneurysm remnant, in 15.6%. WEB shape modification was quantified by a semiautomated approach on CT scans. Time courses were evaluated graphically and analytically; association analyses were performed by linear mixed-effects regression models.
Results:
In 29/32 WEB devices (90.6%), the reduction in height was found to be at least 5%. The decrease in height with time was significantly associated with the time interval in days since the intervention (P < .0001): A stronger decrease in WEB height was associated with a longer time since the intervention (median reduction in 1 year, 19.2%; range, 8.6%-52.3%). No significant association was found with the quality of aneurysm occlusion, device size, rupture status of the aneurysm, aneurysm location, and reintervention rate.
Conclusions:
Shape modification was common in WEB-treated intracranial aneurysms with a median height reduction of 19.2% in 1 year. The quality of aneurysm occlusion was not associated with WEB modification.
