The impact of postoperative aspirin in patients undergoing Woven EndoBridge: a multicenter, institutional, propensity score-matched analysis

Adam A. Dmytriw; Basel Musmar; Hamza Salim; Assala Aslan; Nicole M. Cancelliere; Rachel M. McLellan; Oktay Algin; Sherief Ghozy; Mahmoud Dibas; Sovann V. Lay; Adrien Guenego; Leonardo Renieri; Joseph Anthony Carnevale; Guillaume Saliou; Panagiotis Mastorakos; Kareem El Naamani; Eimad Shotar; Kevin Premat; Markus A. Möhlenbruch; Michael Kral; Omer Doron; Charlotte Chung; Mohamed M. Salem; Ivan Lylyk; Paul M. Foreman; Jay A. Vachhani; Hamza Shaikh; Vedran Župančić; Muhammad Ubaid Hafeez; Joshua S. Catapano; Muhammad Waqas; Vincent M. Tutino; Mohamed K. Ibrahim; Marwa A. Mohammed; Cetin Imamoglu; Ahmet Bayrak; James D. Rabinov; Yifan Ren; Clemens M. Schirmer; Mariangela Piano; Anna Luisa Kuhn; Caterina Michelozzi; Stephanie Elens; Zuha Hasan; Robert M. Starke; Ameer E. Hassan; Mark Ogilvie; Anh Nguyen; Jesse Jones; Waleed Brinjikji; Marie Teresa Nawka; Marios Nikos Psychogios; Christian Ulfert; Jose Danilo Bengzon Diestro; Bryan Pukenas; Jan Karl Burkhardt; Thien J. Huynh; Juan Carlos Martinez-Gutierrez; Muhammed Amir Essibayi; Sunil A. Sheth; Gary Spiegel; Rabih Tawk; Boris Lubicz; Pietro Panni; Ajit S. Puri; Guglielmo Pero; Erez Nossek; Eytan Raz; Monika Killer-Oberpfalzer; Christoph J. Griessenauer; Hamed Asadi; Adnan H. Siddiqui; Allan L. Brook; David Altschul; Andrew F. Ducruet; Felipe C. Albuquerque; Robert W. Regenhardt; Christopher J. Stapleton; Peter Kan; Vladimir Kalousek; Pedro Lylyk; Srikanth Reddy Boddu; Jared Knopman; Mohammad A. Aziz-Sultan; Stavropoula I. Tjoumakaris; Frédéric Clarençon; Nicola Limbucci; Hugo H. Cuellar; Pascal M. Jabbour; Vitor M. Pereira; Aman B. Patel; Nimer Adeeb

doi:10.1136/jnis-2023-021082

The impact of postoperative aspirin in patients undergoing Woven EndoBridge: a multicenter, institutional, propensity score-matched analysis

Adam A. Dmytriw, Basel Musmar, Hamza Salim, Assala Aslan, Nicole M. Cancelliere, Rachel M. McLellan, Oktay Algin, Sherief Ghozy, Mahmoud Dibas, Sovann V. Lay, Adrien Guenego, Leonardo Renieri, Joseph Anthony Carnevale, Guillaume Saliou, Panagiotis Mastorakos, Kareem El Naamani, Eimad Shotar, Kevin Premat, Markus A. Möhlenbruch, Michael KralOmer Doron, Charlotte Chung, Mohamed M. Salem, Ivan Lylyk, Paul M. Foreman, Jay A. Vachhani, Hamza Shaikh, Vedran Župančić, Muhammad Ubaid Hafeez, Joshua S. Catapano, Muhammad Waqas, Vincent M. Tutino, Mohamed K. Ibrahim, Marwa A. Mohammed, Cetin Imamoglu, Ahmet Bayrak, James D. Rabinov, Yifan Ren, Clemens M. Schirmer, Mariangela Piano, Anna Luisa Kuhn, Caterina Michelozzi, Stephanie Elens, Zuha Hasan, Robert M. Starke, Ameer E. Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marie Teresa Nawka, Marios Nikos Psychogios, Christian Ulfert, Jose Danilo Bengzon Diestro, Bryan Pukenas, Jan Karl Burkhardt, Thien J. Huynh, Juan Carlos Martinez-Gutierrez, Muhammed Amir Essibayi, Sunil A. Sheth, Gary Spiegel, Rabih Tawk, Boris Lubicz, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Erez Nossek, Eytan Raz, Monika Killer-Oberpfalzer, Christoph J. Griessenauer, Hamed Asadi, Adnan H. Siddiqui, Allan L. Brook, David Altschul, Andrew F. Ducruet, Felipe C. Albuquerque, Robert W. Regenhardt, Christopher J. Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Reddy Boddu, Jared Knopman, Mohammad A. Aziz-Sultan, Stavropoula I. Tjoumakaris, Frédéric Clarençon, Nicola Limbucci, Hugo H. Cuellar, Pascal M. Jabbour, Vitor M. Pereira, Aman B. Patel, Nimer Adeeb

Radiology

Research output: Contribution to journal › Article › peer-review

Abstract

Background The Woven EndoBridge (WEB) device is frequently used for the treatment of intracranial aneurysms. Postoperative management, including the use of aspirin, varies among clinicians and institutions, but its impact on the outcomes of the WEB has not been thoroughly investigated. Methods This was a retrospective, multicenter study involving 30 academic institutions in North America, South America, and Europe. Data from 1492 patients treated with the WEB device were included. Patients were categorized into two groups based on their postoperative use of aspirin (aspirin group: n=1124, non-aspirin group: n=368). Data points included patient demographics, aneurysm characteristics, procedural details, complications, and angiographic and functional outcomes. Propensity score matching (PSM) was applied to balance variables between the two groups. Results Prior to PSM, the aspirin group exhibited significantly higher rates of modified Rankin scale (mRS) mRS 0–1 and mRS 0–2 (89.8% vs 73.4% and 94.1% vs 79.8%, p<0.001), lower rates of mortality (1.6% vs 8.6%, p<0.001), and higher major compaction rates (13.4% vs 7%, p<0.001). Post-PSM, the aspirin group showed significantly higher rates of retreatment (p=0.026) and major compaction (p=0.037) while maintaining its higher rates of good functional outcomes and lower mortality rates. In the multivariable regression, aspirin was associated with higher rates of mRS 0–1 (OR 2.166; 95% CI 1.16 to 4, p=0.016) and mRS 0–2 (OR 2.817; 95% CI 1.36 to 5.88, p=0.005) and lower rates of mortality (OR 0.228; 95% CI 0.06 to 0.83, p=0.025). However, it was associated with higher rates of retreatment (OR 2.471; 95% CI 1.11 to 5.51, p=0.027). Conclusions Aspirin use post-WEB treatment may lead to better functional outcomes and lower mortality but with higher retreatment rates. These insights are crucial for postoperative management after WEB procedures, but further studies are necessary for validation.

Original language	English (US)
Article number	jnis-2023-021082
Journal	Journal of neurointerventional surgery
DOIs	https://doi.org/10.1136/jnis-2023-021082
State	Accepted/In press - 2024

ASJC Scopus subject areas

Surgery
Clinical Neurology

Access to Document

10.1136/jnis-2023-021082

Cite this

Dmytriw, A. A., Musmar, B., Salim, H., Aslan, A., Cancelliere, N. M., McLellan, R. M., Algin, O., Ghozy, S., Dibas, M., Lay, S. V., Guenego, A., Renieri, L., Carnevale, J. A., Saliou, G., Mastorakos, P., Naamani, K. E., Shotar, E., Premat, K., Möhlenbruch, M. A., ... Adeeb, N. (Accepted/In press). The impact of postoperative aspirin in patients undergoing Woven EndoBridge: a multicenter, institutional, propensity score-matched analysis. Journal of neurointerventional surgery, Article jnis-2023-021082. https://doi.org/10.1136/jnis-2023-021082

Dmytriw, AA, Musmar, B, Salim, H, Aslan, A, Cancelliere, NM, McLellan, RM, Algin, O, Ghozy, S, Dibas, M, Lay, SV, Guenego, A, Renieri, L, Carnevale, JA, Saliou, G, Mastorakos, P, Naamani, KE, Shotar, E, Premat, K, Möhlenbruch, MA, Kral, M, Doron, O, Chung, C, Salem, MM, Lylyk, I, Foreman, PM, Vachhani, JA, Shaikh, H, Župančić, V, Hafeez, MU, Catapano, JS, Waqas, M, Tutino, VM, Ibrahim, MK, Mohammed, MA, Imamoglu, C, Bayrak, A, Rabinov, JD, Ren, Y, Schirmer, CM, Piano, M, Kuhn, AL, Michelozzi, C, Elens, S, Hasan, Z, Starke, RM, Hassan, AE, Ogilvie, M, Nguyen, A, Jones, J, Brinjikji, W, Nawka, MT, Psychogios, MN, Ulfert, C, Bengzon Diestro, JD, Pukenas, B, Burkhardt, JK, Huynh, TJ, Martinez-Gutierrez, JC, Essibayi, MA, Sheth, SA, Spiegel, G, Tawk, R, Lubicz, B, Panni, P, Puri, AS, Pero, G, Nossek, E, Raz, E, Killer-Oberpfalzer, M, Griessenauer, CJ, Asadi, H, Siddiqui, AH, Brook, AL, Altschul, D, Ducruet, AF, Albuquerque, FC, Regenhardt, RW, Stapleton, CJ, Kan, P, Kalousek, V, Lylyk, P, Boddu, SR, Knopman, J, Aziz-Sultan, MA, Tjoumakaris, SI, Clarençon, F, Limbucci, N, Cuellar, HH, Jabbour, PM, Pereira, VM, Patel, AB & Adeeb, N 2024, 'The impact of postoperative aspirin in patients undergoing Woven EndoBridge: a multicenter, institutional, propensity score-matched analysis', Journal of neurointerventional surgery. https://doi.org/10.1136/jnis-2023-021082

@article{ec947065d8164fe68e41f50f5e7541a6,

title = "The impact of postoperative aspirin in patients undergoing Woven EndoBridge: a multicenter, institutional, propensity score-matched analysis",

abstract = "Background The Woven EndoBridge (WEB) device is frequently used for the treatment of intracranial aneurysms. Postoperative management, including the use of aspirin, varies among clinicians and institutions, but its impact on the outcomes of the WEB has not been thoroughly investigated. Methods This was a retrospective, multicenter study involving 30 academic institutions in North America, South America, and Europe. Data from 1492 patients treated with the WEB device were included. Patients were categorized into two groups based on their postoperative use of aspirin (aspirin group: n=1124, non-aspirin group: n=368). Data points included patient demographics, aneurysm characteristics, procedural details, complications, and angiographic and functional outcomes. Propensity score matching (PSM) was applied to balance variables between the two groups. Results Prior to PSM, the aspirin group exhibited significantly higher rates of modified Rankin scale (mRS) mRS 0–1 and mRS 0–2 (89.8% vs 73.4% and 94.1% vs 79.8%, p<0.001), lower rates of mortality (1.6% vs 8.6%, p<0.001), and higher major compaction rates (13.4% vs 7%, p<0.001). Post-PSM, the aspirin group showed significantly higher rates of retreatment (p=0.026) and major compaction (p=0.037) while maintaining its higher rates of good functional outcomes and lower mortality rates. In the multivariable regression, aspirin was associated with higher rates of mRS 0–1 (OR 2.166; 95% CI 1.16 to 4, p=0.016) and mRS 0–2 (OR 2.817; 95% CI 1.36 to 5.88, p=0.005) and lower rates of mortality (OR 0.228; 95% CI 0.06 to 0.83, p=0.025). However, it was associated with higher rates of retreatment (OR 2.471; 95% CI 1.11 to 5.51, p=0.027). Conclusions Aspirin use post-WEB treatment may lead to better functional outcomes and lower mortality but with higher retreatment rates. These insights are crucial for postoperative management after WEB procedures, but further studies are necessary for validation.",

author = "Dmytriw, {Adam A.} and Basel Musmar and Hamza Salim and Assala Aslan and Cancelliere, {Nicole M.} and McLellan, {Rachel M.} and Oktay Algin and Sherief Ghozy and Mahmoud Dibas and Lay, {Sovann V.} and Adrien Guenego and Leonardo Renieri and Carnevale, {Joseph Anthony} and Guillaume Saliou and Panagiotis Mastorakos and Naamani, {Kareem El} and Eimad Shotar and Kevin Premat and M{\"o}hlenbruch, {Markus A.} and Michael Kral and Omer Doron and Charlotte Chung and Salem, {Mohamed M.} and Ivan Lylyk and Foreman, {Paul M.} and Vachhani, {Jay A.} and Hamza Shaikh and Vedran {\v Z}upan{\v c}i{\'c} and Hafeez, {Muhammad Ubaid} and Catapano, {Joshua S.} and Muhammad Waqas and Tutino, {Vincent M.} and Ibrahim, {Mohamed K.} and Mohammed, {Marwa A.} and Cetin Imamoglu and Ahmet Bayrak and Rabinov, {James D.} and Yifan Ren and Schirmer, {Clemens M.} and Mariangela Piano and Kuhn, {Anna Luisa} and Caterina Michelozzi and Stephanie Elens and Zuha Hasan and Starke, {Robert M.} and Hassan, {Ameer E.} and Mark Ogilvie and Anh Nguyen and Jesse Jones and Waleed Brinjikji and Nawka, {Marie Teresa} and Psychogios, {Marios Nikos} and Christian Ulfert and {Bengzon Diestro}, {Jose Danilo} and Bryan Pukenas and Burkhardt, {Jan Karl} and Huynh, {Thien J.} and Martinez-Gutierrez, {Juan Carlos} and Essibayi, {Muhammed Amir} and Sheth, {Sunil A.} and Gary Spiegel and Rabih Tawk and Boris Lubicz and Pietro Panni and Puri, {Ajit S.} and Guglielmo Pero and Erez Nossek and Eytan Raz and Monika Killer-Oberpfalzer and Griessenauer, {Christoph J.} and Hamed Asadi and Siddiqui, {Adnan H.} and Brook, {Allan L.} and David Altschul and Ducruet, {Andrew F.} and Albuquerque, {Felipe C.} and Regenhardt, {Robert W.} and Stapleton, {Christopher J.} and Peter Kan and Vladimir Kalousek and Pedro Lylyk and Boddu, {Srikanth Reddy} and Jared Knopman and Aziz-Sultan, {Mohammad A.} and Tjoumakaris, {Stavropoula I.} and Fr{\'e}d{\'e}ric Claren{\c c}on and Nicola Limbucci and Cuellar, {Hugo H.} and Jabbour, {Pascal M.} and Pereira, {Vitor M.} and Patel, {Aman B.} and Nimer Adeeb",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2024",

doi = "10.1136/jnis-2023-021082",

language = "English (US)",

journal = "Journal of neurointerventional surgery",

issn = "1759-8478",

publisher = "BMJ Publishing Group",

}

TY - JOUR

T1 - The impact of postoperative aspirin in patients undergoing Woven EndoBridge

T2 - a multicenter, institutional, propensity score-matched analysis

AU - Dmytriw, Adam A.

AU - Musmar, Basel

AU - Salim, Hamza

AU - Aslan, Assala

AU - Cancelliere, Nicole M.

AU - McLellan, Rachel M.

AU - Algin, Oktay

AU - Ghozy, Sherief

AU - Dibas, Mahmoud

AU - Lay, Sovann V.

AU - Guenego, Adrien

AU - Renieri, Leonardo

AU - Carnevale, Joseph Anthony

AU - Saliou, Guillaume

AU - Mastorakos, Panagiotis

AU - Naamani, Kareem El

AU - Shotar, Eimad

AU - Premat, Kevin

AU - Möhlenbruch, Markus A.

AU - Kral, Michael

AU - Doron, Omer

AU - Chung, Charlotte

AU - Salem, Mohamed M.

AU - Lylyk, Ivan

AU - Foreman, Paul M.

AU - Vachhani, Jay A.

AU - Shaikh, Hamza

AU - Župančić, Vedran

AU - Hafeez, Muhammad Ubaid

AU - Catapano, Joshua S.

AU - Waqas, Muhammad

AU - Tutino, Vincent M.

AU - Ibrahim, Mohamed K.

AU - Mohammed, Marwa A.

AU - Imamoglu, Cetin

AU - Bayrak, Ahmet

AU - Rabinov, James D.

AU - Ren, Yifan

AU - Schirmer, Clemens M.

AU - Piano, Mariangela

AU - Kuhn, Anna Luisa

AU - Michelozzi, Caterina

AU - Elens, Stephanie

AU - Hasan, Zuha

AU - Starke, Robert M.

AU - Hassan, Ameer E.

AU - Ogilvie, Mark

AU - Nguyen, Anh

AU - Jones, Jesse

AU - Brinjikji, Waleed

AU - Nawka, Marie Teresa

AU - Psychogios, Marios Nikos

AU - Ulfert, Christian

AU - Bengzon Diestro, Jose Danilo

AU - Pukenas, Bryan

AU - Burkhardt, Jan Karl

AU - Huynh, Thien J.

AU - Martinez-Gutierrez, Juan Carlos

AU - Essibayi, Muhammed Amir

AU - Sheth, Sunil A.

AU - Spiegel, Gary

AU - Tawk, Rabih

AU - Lubicz, Boris

AU - Panni, Pietro

AU - Puri, Ajit S.

AU - Pero, Guglielmo

AU - Nossek, Erez

AU - Raz, Eytan

AU - Killer-Oberpfalzer, Monika

AU - Griessenauer, Christoph J.

AU - Asadi, Hamed

AU - Siddiqui, Adnan H.

AU - Brook, Allan L.

AU - Altschul, David

AU - Ducruet, Andrew F.

AU - Albuquerque, Felipe C.

AU - Regenhardt, Robert W.

AU - Stapleton, Christopher J.

AU - Kan, Peter

AU - Kalousek, Vladimir

AU - Lylyk, Pedro

AU - Boddu, Srikanth Reddy

AU - Knopman, Jared

AU - Aziz-Sultan, Mohammad A.

AU - Tjoumakaris, Stavropoula I.

AU - Clarençon, Frédéric

AU - Limbucci, Nicola

AU - Cuellar, Hugo H.

AU - Jabbour, Pascal M.

AU - Pereira, Vitor M.

AU - Patel, Aman B.

AU - Adeeb, Nimer

PY - 2024

Y1 - 2024

N2 - Background The Woven EndoBridge (WEB) device is frequently used for the treatment of intracranial aneurysms. Postoperative management, including the use of aspirin, varies among clinicians and institutions, but its impact on the outcomes of the WEB has not been thoroughly investigated. Methods This was a retrospective, multicenter study involving 30 academic institutions in North America, South America, and Europe. Data from 1492 patients treated with the WEB device were included. Patients were categorized into two groups based on their postoperative use of aspirin (aspirin group: n=1124, non-aspirin group: n=368). Data points included patient demographics, aneurysm characteristics, procedural details, complications, and angiographic and functional outcomes. Propensity score matching (PSM) was applied to balance variables between the two groups. Results Prior to PSM, the aspirin group exhibited significantly higher rates of modified Rankin scale (mRS) mRS 0–1 and mRS 0–2 (89.8% vs 73.4% and 94.1% vs 79.8%, p<0.001), lower rates of mortality (1.6% vs 8.6%, p<0.001), and higher major compaction rates (13.4% vs 7%, p<0.001). Post-PSM, the aspirin group showed significantly higher rates of retreatment (p=0.026) and major compaction (p=0.037) while maintaining its higher rates of good functional outcomes and lower mortality rates. In the multivariable regression, aspirin was associated with higher rates of mRS 0–1 (OR 2.166; 95% CI 1.16 to 4, p=0.016) and mRS 0–2 (OR 2.817; 95% CI 1.36 to 5.88, p=0.005) and lower rates of mortality (OR 0.228; 95% CI 0.06 to 0.83, p=0.025). However, it was associated with higher rates of retreatment (OR 2.471; 95% CI 1.11 to 5.51, p=0.027). Conclusions Aspirin use post-WEB treatment may lead to better functional outcomes and lower mortality but with higher retreatment rates. These insights are crucial for postoperative management after WEB procedures, but further studies are necessary for validation.

AB - Background The Woven EndoBridge (WEB) device is frequently used for the treatment of intracranial aneurysms. Postoperative management, including the use of aspirin, varies among clinicians and institutions, but its impact on the outcomes of the WEB has not been thoroughly investigated. Methods This was a retrospective, multicenter study involving 30 academic institutions in North America, South America, and Europe. Data from 1492 patients treated with the WEB device were included. Patients were categorized into two groups based on their postoperative use of aspirin (aspirin group: n=1124, non-aspirin group: n=368). Data points included patient demographics, aneurysm characteristics, procedural details, complications, and angiographic and functional outcomes. Propensity score matching (PSM) was applied to balance variables between the two groups. Results Prior to PSM, the aspirin group exhibited significantly higher rates of modified Rankin scale (mRS) mRS 0–1 and mRS 0–2 (89.8% vs 73.4% and 94.1% vs 79.8%, p<0.001), lower rates of mortality (1.6% vs 8.6%, p<0.001), and higher major compaction rates (13.4% vs 7%, p<0.001). Post-PSM, the aspirin group showed significantly higher rates of retreatment (p=0.026) and major compaction (p=0.037) while maintaining its higher rates of good functional outcomes and lower mortality rates. In the multivariable regression, aspirin was associated with higher rates of mRS 0–1 (OR 2.166; 95% CI 1.16 to 4, p=0.016) and mRS 0–2 (OR 2.817; 95% CI 1.36 to 5.88, p=0.005) and lower rates of mortality (OR 0.228; 95% CI 0.06 to 0.83, p=0.025). However, it was associated with higher rates of retreatment (OR 2.471; 95% CI 1.11 to 5.51, p=0.027). Conclusions Aspirin use post-WEB treatment may lead to better functional outcomes and lower mortality but with higher retreatment rates. These insights are crucial for postoperative management after WEB procedures, but further studies are necessary for validation.

UR - http://www.scopus.com/inward/record.url?scp=85183924516&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85183924516&partnerID=8YFLogxK

U2 - 10.1136/jnis-2023-021082

DO - 10.1136/jnis-2023-021082

M3 - Article

C2 - 38238006

AN - SCOPUS:85183924516

SN - 1759-8478

JO - Journal of neurointerventional surgery

JF - Journal of neurointerventional surgery

M1 - jnis-2023-021082

ER -

The impact of postoperative aspirin in patients undergoing Woven EndoBridge: a multicenter, institutional, propensity score-matched analysis

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this