RT Journal Article SR Electronic T1 Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of a Multicenter Retrospective Study JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 906 OP 911 DO 10.3174/ajnr.A8324 VO 45 IS 7 A1 Mastorakos, Panagiotis A1 Naamani, Kareem El A1 Adeeb, Nimer A1 Lan, Mathews A1 Castiglione, James A1 Khanna, Omaditya A1 Ghosh, Ritam A1 Bengzon Diestro, Jose Danilo A1 Dibas, Mahmoud A1 McLellan, Rachel M. A1 Algin, Oktay A1 Ghozy, Sherief A1 Cancelliere, Nicole M. A1 Aslan, Assala A1 Cuellar-Saenz, Hugo H. A1 Lay, Sovann V. A1 Guenego, Adrien A1 Renieri, Leonardo A1 Carnevale, Joseph A1 Saliou, Guillaume A1 Shotar, Eimad A1 Premat, Kevin A1 Möhlenbruch, Markus A1 Kral, Michael A1 Vranic, Justin E. A1 Chung, Charlotte A1 Salem, Mohamed M. A1 Lylyk, Ivan A1 Foreman, Paul M. A1 Vachhani, Jay A. A1 Shaikh, Hamza A1 Župančić, Vedran A1 Hafeez, Muhammad U. A1 Catapano, Joshua A1 Waqas, Muhammad A1 Tutino, Vincent M. A1 Ibrahim, Mohamed K. A1 Mohammed, Marwa A. A1 Rabinov, James D. A1 Ren, Yifan A1 Schirmer, Clemens M. A1 Piano, Mariangela A1 Bullrich, Maria Bres A1 Mayich, Michael A1 Kühn, Anna L. A1 Michelozzi, Caterina A1 Elens, Stéphanie A1 Starke, Robert M. A1 Hassan, Ameer E. A1 Ogilvie, Mark A1 Nguyen, Anh A1 Jones, Jesse A1 Brinjikji, Waleed A1 Psychogios, Marios A1 Ulfert, Christian A1 Spears, Julian A1 Jankowitz, Brian T. A1 Burkhardt, Jan-Karl A1 Domingo, Ricardo A. A1 Huynh, Thien A1 Tawk, Rabih G. A1 Lubicz, Boris A1 Nawka, Marie T. A1 Panni, Pietro A1 Puri, Ajit S. A1 Pero, Guglielmo A1 Nossek, Erez A1 Raz, Eytan A1 Killer-Oberpfalzer, Monika A1 Ozates, M. Ozgur A1 Ayberk, Giyas A1 Regenhardt, Robert W. A1 Griessenauer, Christoph J. A1 Asadi, Hamed A1 Siddiqui, Adnan A1 Ducruet, Andrew F. A1 Albuquerque, Felipe C. A1 Patel, Nirav J. A1 Stapleton, Christopher J. A1 Kan, Peter A1 Kalousek, Vladimir A1 Lylyk, Pedro A1 Boddu, Srikanth A1 Knopman, Jared A1 Aziz-Sultan, Mohammad A. A1 Clarençon, Frédéric A1 Limbucci, Nicola A1 Zanaty, Mario A1 Martinez-Gutierrez, Juan Carlos A1 Sheth, Sunil A1 Spiegel, Gary A1 Abbas, Rawad A1 Amllay, Abdelaziz A1 Tjoumakaris, Stavropoula I. A1 Gooch, Michael R. A1 Herial, Nabeel A. A1 Rosenwasser, Robert H. A1 Zarzour, Hekmat A1 Schmidt, Richard F. A1 Pereira, Vitor Mendes A1 Patel, Aman B. A1 Jabbour, Pascal M. A1 Dmytriw, Adam A. YR 2024 UL http://www.ajnr.org/content/45/7/906.abstract AB BACKGROUND AND PURPOSE: Despite the numerous studies evaluating the occlusion rates of aneurysms following WEB embolization, there are limited studies identifying predictors of occlusion. Our purpose was to identify predictors of aneurysm occlusion and the need for retreatment.MATERIALS AND METHODS: This is a review of a prospectively maintained database across 30 academic institutions. We included patients with previously untreated cerebral aneurysms embolized using the WEB who had available intraprocedural data and long-term follow-up.RESULTS: We studied 763 patients with a mean age of 59.9 (SD, 11.7) years. Complete aneurysm occlusion was observed in 212/726 (29.2%) cases, and contrast stasis was observed in 485/537 (90.3%) of nonoccluded aneurysms. At the final follow-up, complete occlusion was achieved in 497/763 (65.1%) patients, and retreatment was required for 56/763 (7.3%) patients. On multivariable analysis, history of smoking, maximal aneurysm diameter, and the presence of an aneurysm wall branch were negative predictors of complete occlusion (OR, 0.5, 0.8, and 0.4, respectively). Maximal aneurysm diameter, the presence of an aneurysm wall branch, posterior circulation location, and male sex increase the chances of retreatment (OR, 1.2, 3.8, 3.0, and 2.3 respectively). Intraprocedural occlusion resulted in a 3-fold increase in the long-term occlusion rate and a 5-fold decrease in the retreatment rate (P < .001), offering a specificity of 87% and a positive predictive value of 85% for long-term occlusion.CONCLUSIONS: Intraprocedural occlusion can be used to predict the chance of long-term aneurysm occlusion and the need for retreatment after embolization with a WEB device. Smoking, aneurysm size, and the presence of an aneurysm wall branch are associated with decreased chances of successful treatment.ROCreceiver operating characteristic