Persistent flow inside the Woven EndoBridge at angiographic follow-up: A multicenter study
2 XLIM - XLIM
3 NEURO - Laboratoire de Neurosciences Intégratives et Cliniques - UFC (UR 481)
4 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
5 Hôpital Charles Nicolle [Rouen]
6 GRC 14 - BIOSFAST - Groupe de recherche clinique Biomarqueurs d’urgence et de réanimation
7 Département de Neuroradiologie [CHU Rouen]
8 Service de Neurologie [CHU Limoges]
9 Département de Neuroradiologie [CHRU Montpellier]
10 LIIE - Laboratoire d'Imagerie Interventionnelle Expérimentale
11 CERIMED - Centre Européen de Recherche en Imagerie médicale
12 Département de Radiologie [Hôpital de la Timone - APHM]
13 CH Colmar
14 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
15 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
16 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
17 CHU Pitié-Salpêtrière [AP-HP]
18 CHU Limoges
19 XLIM-BIO-SANTÉ - BIO-SANTÉ
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Résumé
Background The occurrence of persistent intra-device filling (BOSS 1, using the Bicêtre Occlusion Scale Score (BOSS)) in aneurysms treated with a Woven Endobridge (WEB) device is infrequent based on angiographic follow-up. To date, three monocentric case series were published studying BOSS 1 cases. Through a multicenter retrospective study, we aimed to report the incidence, and risk factors of intra-WEB persistent filling. Methods We reached out to European academic centers that treat patients using WEB devices and requested de-identified data of patients treated with a WEB device and underwent angiographic follow-up, at least 3 months after embolization, to assess the BOSS 1 occlusion score. We compared baseline characteristics, treatment modalities, and aneurysm data of the included BOSS 1 patients with those of a control group consisting of non-BOSS 1 patients ( n = 116) who had an available angiographic follow-up. Univariable and multivariable models were employed for analysis. Results Among the pooled sample of 591 aneurysms treated with WEB, the rate of persistent flow (BOSS 1) at angiographic follow-up was 5.2% ( n = 31 out of 591), performed after an average of 8.7 ± 6.3 months. In the multivariable-adjusted analysis, dual antiplatelet therapy in the postoperative period (adjusted odds ratio [aOR] 4.3 [95% CI 1.3–14.2]), and WEB undersizing (aOR 10.8 [95% CI 2.9–40]) were independently associated with a BOSS 1 persistent flow result. Conclusion Persistent blood flow within the WEB device during angiographic follow-up (BOSS 1) is an uncommon occurrence. Our findings indicate that post-procedural dual antiplatelet therapy and undersizing of the WEB device are independently associated with the presence of BOSS 1 at follow-up.