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Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study

Vaishnav, Dhrumil
Essibayi, Muhammed Amir
Musmar, Basel
Adeeb, Nimer
Salim, Hamza Adel
Aslan, Assala
Cancelliere, Nicole M
McLellan, Rachel M
Algin, Oktay
Ghozy, Sherief
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Authors
Vaishnav, Dhrumil
Essibayi, Muhammed Amir
Musmar, Basel
Adeeb, Nimer
Salim, Hamza Adel
Aslan, Assala
Cancelliere, Nicole M
McLellan, Rachel M
Algin, Oktay
Ghozy, Sherief
Lay, Sovann V
Guenego, Adrien
Renieri, Leonardo
Carnevale, Joseph
Saliou, Guillaume
Mastorakos, Panagiotis
El Naamani, Kareem
Shotar, Eimad
Premat, Kevin
Möhlenbruch, Markus
Kral, Michael
Doron, Omer
Chung, Charlotte
Salem, Mohamed M
Lylyk, Ivan
Foreman, Paul M
Vachhani, Jay A
Shaikh, Hamza
Župančić, Vedran
Hafeez, Muhammad U
Catapano, Joshua
Waqas, Muhammad
Ayberk, Giyas
Celal Gunes, Yasin
Rabinov, James D
Ren, Yifan
Schirmer, Clemens M
Piano, Mariangela
Kühn, Anna L
Michelozzi, Caterina
Elens, Stéphanie
Starke, Robert M
Hassan, Ameer E
Ogilvie, Mark
Nguyen, Anh
Jones, Jesse
Brinjikji, Waleed
Nawka, Marie T
Psychogios, Marios
Ulfert, Christian
Diestro, Jose Danilo Bengzon
Pukenas, Bryan
Burkhardt, Jan-Karl
Huynh, Thien
Martinez-Gutierrez, Juan Carlos
Sheth, Sunil A
Spiegel, Gary
Tawk, Rabih G
Lubicz, Boris
Panni, Pietro
Puri, Ajit S
Pero, Guglielmo
Nossek, Erez
Raz, Eytan
Killer-Oberpfalzer, Monika
Griessenauer, Christoph J
Asadi, Hamed
Siddiqui, Adnan
Brook, Allan L
Haranhalli, Neil
Ducruet, Andrew F
Albuquerque, Felipe C
Regenhardt, Robert W
Stapleton, Christopher J
Kan, Peter
Kalousek, Vladimir
Lylyk, Pedro
Boddu, Srikanth
Knopman, Jared
Aziz-Sultan, Mohammad A
Tjoumakaris, Stavropoula I
Clarençon, Frédéric
Limbucci, Nicola
Cuellar-Saenz, Hugo H
Jabbour, Pascal M
Mendes Pereira, Vitor
Patel, Aman B
Altschul, David J
Dmytriw, Adam A
Student Authors
Faculty Advisor
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UMass Chan Affiliations
Document Type
Journal Article
Publication Date
2025-01-31
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Abstract

Objective: Tobacco smoking is among the factors known to significantly augment the risk of untreated intracranial aneurysm (IA) growth and rupture. Smoking appears to have a variable effect on different endovascular treatment modalities. The impact of smoking on the safety, efficacy, and outcomes of Woven EndoBridge (WEB) device use for wide-neck IAs has not been evaluated. This study aimed to investigate the outcomes of WEB devices by smoking status.

Methods: A retrospective multicenter analysis was conducted on the data of patients from 36 sites worldwide treated with the WEB device for intracranial saccular aneurysms. Patients were stratified based on smoking status (current, former, and never smokers). The Student t-test and chi-square test were performed for continuous and categorical variables, respectively. Multivariable logistic regression was used to adjust for confounders.

Results: Of 1376 patients with available smoking status, 504 were current smokers, 358 were former smokers, and 514 were never smokers. Upon adjusting for significant confounders, no association was found between smoking and recurrence outcomes (OR 1.39, 95% CI 0.69-2.80; p = 0.36), thromboembolic and hemorrhagic complications, and mortality among IAs treated with the WEB device. There was no statistically significant difference in outcomes between former and never smokers (OR 1.23, 95% CI 0.70-2.18; p = 0.46). The location of aneurysms differed between smoking groups, with former smokers having more anterior circulation aneurysms compared with current and never smokers (99.0% vs 96.9% vs 95.3%; p = 0.01). In terms of clinical symptoms, headache and dizziness were more common in the never smokers compared with current and former smokers (13.9% vs 8.9% vs 7.7%, p = 0.01).

Conclusions: This large-scale study suggests no significant correlation between smoking and the recurrence of IAs treated with the WEB device. Biological studies are warranted to better understand the biological impact of smoking on the growth and rupture of treated IAs.

Source

Vaishnav D, Essibayi MA, Musmar B, Adeeb N, Salim HA, Aslan A, Cancelliere NM, McLellan RM, Algin O, Ghozy S, Lay SV, Guenego A, Renieri L, Carnevale J, Saliou G, Mastorakos P, El Naamani K, Shotar E, Premat K, Möhlenbruch M, Kral M, Doron O, Chung C, Salem MM, Lylyk I, Foreman PM, Vachhani JA, Shaikh H, Župančić V, Hafeez MU, Catapano J, Waqas M, Ayberk G, Celal Gunes Y, Rabinov JD, Ren Y, Schirmer CM, Piano M, Kühn AL, Michelozzi C, Elens S, Starke RM, Hassan AE, Ogilvie M, Nguyen A, Jones J, Brinjikji W, Nawka MT, Psychogios M, Ulfert C, Diestro JDB, Pukenas B, Burkhardt JK, Huynh T, Martinez-Gutierrez JC, Sheth SA, Spiegel G, Tawk RG, Lubicz B, Panni P, Puri AS, Pero G, Nossek E, Raz E, Killer-Oberpfalzer M, Griessenauer CJ, Asadi H, Siddiqui A, Brook AL, Haranhalli N, Ducruet AF, Albuquerque FC, Regenhardt RW, Stapleton CJ, Kan P, Kalousek V, Lylyk P, Boddu S, Knopman J, Aziz-Sultan MA, Tjoumakaris SI, Clarençon F, Limbucci N, Cuellar-Saenz HH, Jabbour PM, Mendes Pereira V, Patel AB, Altschul DJ, Dmytriw AA; WorldWideWEB Consortium. Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study. J Neurosurg. 2025 Jan 31:1-9. doi: 10.3171/2024.10.JNS241058. Epub ahead of print. PMID: 39889291.

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DOI
10.3171/2024.10.JNS241058
PubMed ID
39889291
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