O-003 Adequate lateral compression is a strong independent predictor of aneurysm occlusion and retreatment after endovascular treatment with WEB

Purpose To determine the effect of lateral compression on aneurysm occlusion after endovascular treatment of intracranial aneurysms with the Woven Endo-Bridge (WEB) device. Methods We retrospectively reviewed intracranial aneurysms treated with WEB without adjunctive flow-diverter or coil usage at our institution. Baseline patient and aneurysm characteristics were collected. Aneurysm occlusion at last follow-up was determined by 3 neurointerventionalists using the WEB occlusion scale. Lateral compression (LC) was determined by (1) measuring the average implanted WEB width at its equator in 2 orthogonal working projections, and (2) subtracting it from the nominal WEB width (LC = nominal - average implanted WEB width). The patient cohort was categorized according to empirically-derived, technically-achievable adequate LC thresholds (table 1). Univariate analysis was conducted using Chi-Square or Fisher’s Exact test. Independent predictors of complete and adequate aneurysm occlusion at last follow-up as well as aneurysm retreatment were determined using multivariate logistic regression analysis. Results 74 aneurysms were included in our study, mean maximum aneurysm size 6.5mm, mean neck size 3.6mm, mean time to last follow-up 12.5 months. Adequate WEB LC was present in 51 aneurysms (69%). At last follow-up, complete and adequate aneurysm occlusion was present in 43 (58%) and 62 (84%) aneurysms, respectively. 8 aneurysms were retreated (11%). There was a statistically-significant higher rate of complete and adequate aneurysm occlusion in aneurysms with adequate WEB LC (table 2). In addition, there was a statistically-significant lower rate of retreatment in aneurysms with adequate WEB LC (table 2). In multivariate logistic regression analysis, independent predictors of complete aneurysm occlusion at last follow-up were adequate WEB LC (odds ratio 24.3, p-value 0.001), maximum aneurysm size (odds ratio 0.5, p-value 0.006), active smoking (odds ratio 0.29, p-value 0.014), and aneurysm location (odds ratio 2.4, p-value 0.04). In addition, adequate WEB LC was an independent predictor of adequate aneurysm occlusion at last follow-up (odds ratio 59.3, p-value 0.03), and retreatment (odds ratio 0.059, p-value 0.04). Conclusion Adequate WEB LC is a strong independent predictor of aneurysm occlusion and retreatment in intracranial aneurysms treated with WEB. Determining whether adequate WEB LC has been attained prior to device detachment may aid in determining the need for WEB resizing and the likelihood of complete aneurysm occlusion at follow-up. Disclosures J. Delgado Almandoz: 2; C; Microvention/Terumo. Y. Kayan: 2; C; Microvention/Terumo. A. Copelan: None. J. Scholz: None.