TY - JOUR
T1 - Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge
T2 - a multicenter retrospective study
AU - WorldWideWEB Consortium
AU - Vaishnav, Dhrumil
AU - Essibayi, Muhammed Amir
AU - Musmar, Basel
AU - Adeeb, Nimer
AU - Salim, Hamza Adel
AU - Aslan, Assala
AU - Cancelliere, Nicole M.
AU - McLellan, Rachel M.
AU - Algin, Oktay
AU - Ghozy, Sherief
AU - Lay, Sovann V.
AU - Guenego, Adrien
AU - Renieri, Leonardo
AU - Carnevale, Joseph
AU - Saliou, Guillaume
AU - Mastorakos, Panagiotis
AU - El Naamani, Kareem
AU - Shotar, Eimad
AU - Premat, Kevin
AU - Möhlenbruch, Markus
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 U.
AU - Catapano, Joshua
AU - Waqas, Muhammad
AU - Ayberk, Giyas
AU - Gunes, Yasin Celal
AU - Rabinov, James D.
AU - Ren, Yifan
AU - Schirmer, Clemens M.
AU - Piano, Mariangela
AU - Kühn, Anna L.
AU - Michelozzi, Caterina
AU - Elens, Stéphanie
AU - Starke, Robert M.
AU - Hassan, Ameer E.
AU - Ogilvie, Mark
AU - Nguyen, Anh
AU - Jones, Jesse
AU - Brinjikji, Waleed
AU - Nawka, Marie T.
AU - Siddiqui, Adnan
AU - Tutino, Vincent M.
N1 - Publisher Copyright:
© 2025 American Association of Neurological Surgeons. All rights reserved.
PY - 2025/6
Y1 - 2025/6
N2 - 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.
AB - 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.
KW - WEB
KW - Woven EndoBridge
KW - aneurysms
KW - intracranial
KW - smoking
KW - vascular disorders
UR - https://www.scopus.com/pages/publications/105007208478
U2 - 10.3171/2024.10.JNS241058
DO - 10.3171/2024.10.JNS241058
M3 - Article
C2 - 39889291
AN - SCOPUS:105007208478
SN - 0022-3085
VL - 142
SP - 1732
EP - 1740
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
IS - 6
ER -