The Effect of Aspirin use following Woven EndoBridge Treatment: A Multicenter Study with Propensity Score-Matching

Basel Musmar; Hamza Adel Salim; Joanna M. Roy; Nimer Adeeb; Antony A. Fuleihan; Elias Atallah; Bachar El Baba; Brian M. Howard; Jonathan A. Grossberg; Kyle W. Scott; Jan Karl Burkhardt; Visish M. Srinivasan; Fernanda Erazu; Eric Sauvageau; Amin Aghaebrahim; Ricardo A. Hanel; Abdelaziz Amllay; Charles Matouk; Andrew Macneil; Nohra Chalouhi; Matthew Koch; Santiago Gomez-Paz; Ramesh Grandhi; Vinay Jaikumar; Elad Levy; Adnan Siddiqui; Yasha Kayan; Alexander Z. Copelan; Josser E. Delgado Almandoz; Haydn Hoffman; Adam Arthur; David M. Hasan; Christina Notarianni; Hugo H. Cuellar; Bharat Guthikonda; Jacques Morcos; Stavropoula I. Tjoumakaris; Michael Reid Gooch; Robert H. Rosenwasser; Pascal Jabbour

doi:10.1017/cjn.2026.10600

The Effect of Aspirin use following Woven EndoBridge Treatment: A Multicenter Study with Propensity Score-Matching

Basel Musmar
, Hamza Adel Salim
, Joanna M. Roy
, Nimer Adeeb
, Antony A. Fuleihan
, Elias Atallah
, Bachar El Baba
, Brian M. Howard
, Jonathan A. Grossberg
, Kyle W. Scott
, Jan Karl Burkhardt
, Visish M. Srinivasan
, Fernanda Erazu
, Eric Sauvageau
, Amin Aghaebrahim
, Ricardo A. Hanel
, Abdelaziz Amllay
, Charles Matouk
, Andrew Macneil
, Nohra Chalouhi

Matthew Koch, Santiago Gomez-Paz, Ramesh Grandhi, Vinay Jaikumar, Elad Levy, Adnan Siddiqui, Yasha Kayan, Alexander Z. Copelan, Josser E. Delgado Almandoz, Haydn Hoffman, Adam Arthur, David M. Hasan, Christina Notarianni, Hugo H. Cuellar, Bharat Guthikonda, Jacques Morcos, Stavropoula I. Tjoumakaris, Michael Reid Gooch, Robert H. Rosenwasser, Pascal Jabbour

Neurosurgery

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Background: The Woven EndoBridge (WEB) device has emerged as a promising option for treating wide-neck bifurcation aneurysms. This multicenter study aimed to evaluate the impact of postoperative aspirin (ASA) use on clinical and angiographic outcomes in patients treated with the WEB device. Methods: We conducted a retrospective multicenter study across 10 academic institutions, analyzing patients with ruptured or unruptured intracranial aneurysms treated with the WEB device. Results: A total of 225 patients were included, with 163 (72.4%) receiving postoperative ASA and 62 (27.6%) in the No AP group. Before PSM, the ASA group demonstrated significantly higher rates of excellent functional outcomes (mRS 0-1: 84% vs. 70%, p = 0.031) and lower mortality (3.3% vs. 13%, p=0.014). Retreatment rates were also significantly lower in the ASA group (8.6% vs. 23%, p = 0.005). After PSM, 120 patients remained (74 ASA, 46 No AP).Retreatment rates remained significantly lower in the ASA group (5.4% vs. 24%, p=0.003), whereas the other outcomes did not reach statistical significance after matching. Conclusion: Postoperative aspirin use following WEB device treatment for intracranial aneurysms was associated with significantly lower retreatment rates, without compromising functional outcomes or mortality rates. These findings support the potential role of aspirin in enhancing aneurysm stability. Further prospective studies are needed to confirm.

Original language	English
Journal	Canadian Journal of Neurological Sciences
DOIs	https://doi.org/10.1017/cjn.2026.10600
State	Accepted/In press - 2026

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Musmar, B., Salim, H. A., Roy, J. M., Adeeb, N., Fuleihan, A. A., Atallah, E., El Baba, B., Howard, B. M., Grossberg, J. A., Scott, K. W., Burkhardt, J. K., Srinivasan, V. M., Erazu, F., Sauvageau, E., Aghaebrahim, A., Hanel, R. A., Amllay, A., Matouk, C., Macneil, A., ... Jabbour, P. (Accepted/In press). The Effect of Aspirin use following Woven EndoBridge Treatment: A Multicenter Study with Propensity Score-Matching. Canadian Journal of Neurological Sciences. https://doi.org/10.1017/cjn.2026.10600

@article{cb4f098e22bf4232896bdf1f09d7b361,

title = "The Effect of Aspirin use following Woven EndoBridge Treatment: A Multicenter Study with Propensity Score-Matching",

abstract = "Background: The Woven EndoBridge (WEB) device has emerged as a promising option for treating wide-neck bifurcation aneurysms. This multicenter study aimed to evaluate the impact of postoperative aspirin (ASA) use on clinical and angiographic outcomes in patients treated with the WEB device. Methods: We conducted a retrospective multicenter study across 10 academic institutions, analyzing patients with ruptured or unruptured intracranial aneurysms treated with the WEB device. Results: A total of 225 patients were included, with 163 (72.4\%) receiving postoperative ASA and 62 (27.6\%) in the No AP group. Before PSM, the ASA group demonstrated significantly higher rates of excellent functional outcomes (mRS 0-1: 84\% vs. 70\%, p = 0.031) and lower mortality (3.3\% vs. 13\%, p=0.014). Retreatment rates were also significantly lower in the ASA group (8.6\% vs. 23\%, p = 0.005). After PSM, 120 patients remained (74 ASA, 46 No AP).Retreatment rates remained significantly lower in the ASA group (5.4\% vs. 24\%, p=0.003), whereas the other outcomes did not reach statistical significance after matching. Conclusion: Postoperative aspirin use following WEB device treatment for intracranial aneurysms was associated with significantly lower retreatment rates, without compromising functional outcomes or mortality rates. These findings support the potential role of aspirin in enhancing aneurysm stability. Further prospective studies are needed to confirm.",

author = "Basel Musmar and Salim, \{Hamza Adel\} and Roy, \{Joanna M.\} and Nimer Adeeb and Fuleihan, \{Antony A.\} and Elias Atallah and \{El Baba\}, Bachar and Howard, \{Brian M.\} and Grossberg, \{Jonathan A.\} and Scott, \{Kyle W.\} and Burkhardt, \{Jan Karl\} and Srinivasan, \{Visish M.\} and Fernanda Erazu and Eric Sauvageau and Amin Aghaebrahim and Hanel, \{Ricardo A.\} and Abdelaziz Amllay and Charles Matouk and Andrew Macneil and Nohra Chalouhi and Matthew Koch and Santiago Gomez-Paz and Ramesh Grandhi and Vinay Jaikumar and Elad Levy and Adnan Siddiqui and Yasha Kayan and Copelan, \{Alexander Z.\} and \{Delgado Almandoz\}, \{Josser E.\} and Haydn Hoffman and Adam Arthur and Hasan, \{David M.\} and Christina Notarianni and Cuellar, \{Hugo H.\} and Bharat Guthikonda and Jacques Morcos and Tjoumakaris, \{Stavropoula I.\} and Gooch, \{Michael Reid\} and Rosenwasser, \{Robert H.\} and Pascal Jabbour",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2026. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation.",

year = "2026",

doi = "10.1017/cjn.2026.10600",

language = "English",

journal = "Canadian Journal of Neurological Sciences",

issn = "0317-1671",

publisher = "Cambridge University Press",

}

Musmar, B, Salim, HA, Roy, JM, Adeeb, N, Fuleihan, AA, Atallah, E, El Baba, B, Howard, BM, Grossberg, JA, Scott, KW, Burkhardt, JK, Srinivasan, VM, Erazu, F, Sauvageau, E, Aghaebrahim, A, Hanel, RA, Amllay, A, Matouk, C, Macneil, A, Chalouhi, N, Koch, M, Gomez-Paz, S, Grandhi, R, Jaikumar, V, Levy, E , Siddiqui, A, Kayan, Y, Copelan, AZ, Delgado Almandoz, JE, Hoffman, H, Arthur, A, Hasan, DM, Notarianni, C, Cuellar, HH, Guthikonda, B, Morcos, J, Tjoumakaris, SI, Gooch, MR, Rosenwasser, RH & Jabbour, P 2026, 'The Effect of Aspirin use following Woven EndoBridge Treatment: A Multicenter Study with Propensity Score-Matching', Canadian Journal of Neurological Sciences. https://doi.org/10.1017/cjn.2026.10600

TY - JOUR

T1 - The Effect of Aspirin use following Woven EndoBridge Treatment

T2 - A Multicenter Study with Propensity Score-Matching

AU - Musmar, Basel

AU - Salim, Hamza Adel

AU - Roy, Joanna M.

AU - Adeeb, Nimer

AU - Fuleihan, Antony A.

AU - Atallah, Elias

AU - El Baba, Bachar

AU - Howard, Brian M.

AU - Grossberg, Jonathan A.

AU - Scott, Kyle W.

AU - Burkhardt, Jan Karl

AU - Srinivasan, Visish M.

AU - Erazu, Fernanda

AU - Sauvageau, Eric

AU - Aghaebrahim, Amin

AU - Hanel, Ricardo A.

AU - Amllay, Abdelaziz

AU - Matouk, Charles

AU - Macneil, Andrew

AU - Chalouhi, Nohra

AU - Koch, Matthew

AU - Gomez-Paz, Santiago

AU - Grandhi, Ramesh

AU - Jaikumar, Vinay

AU - Levy, Elad

AU - Siddiqui, Adnan

AU - Kayan, Yasha

AU - Copelan, Alexander Z.

AU - Delgado Almandoz, Josser E.

AU - Hoffman, Haydn

AU - Arthur, Adam

AU - Hasan, David M.

AU - Notarianni, Christina

AU - Cuellar, Hugo H.

AU - Guthikonda, Bharat

AU - Morcos, Jacques

AU - Tjoumakaris, Stavropoula I.

AU - Gooch, Michael Reid

AU - Rosenwasser, Robert H.

AU - Jabbour, Pascal

PY - 2026

Y1 - 2026

N2 - Background: The Woven EndoBridge (WEB) device has emerged as a promising option for treating wide-neck bifurcation aneurysms. This multicenter study aimed to evaluate the impact of postoperative aspirin (ASA) use on clinical and angiographic outcomes in patients treated with the WEB device. Methods: We conducted a retrospective multicenter study across 10 academic institutions, analyzing patients with ruptured or unruptured intracranial aneurysms treated with the WEB device. Results: A total of 225 patients were included, with 163 (72.4%) receiving postoperative ASA and 62 (27.6%) in the No AP group. Before PSM, the ASA group demonstrated significantly higher rates of excellent functional outcomes (mRS 0-1: 84% vs. 70%, p = 0.031) and lower mortality (3.3% vs. 13%, p=0.014). Retreatment rates were also significantly lower in the ASA group (8.6% vs. 23%, p = 0.005). After PSM, 120 patients remained (74 ASA, 46 No AP).Retreatment rates remained significantly lower in the ASA group (5.4% vs. 24%, p=0.003), whereas the other outcomes did not reach statistical significance after matching. Conclusion: Postoperative aspirin use following WEB device treatment for intracranial aneurysms was associated with significantly lower retreatment rates, without compromising functional outcomes or mortality rates. These findings support the potential role of aspirin in enhancing aneurysm stability. Further prospective studies are needed to confirm.

AB - Background: The Woven EndoBridge (WEB) device has emerged as a promising option for treating wide-neck bifurcation aneurysms. This multicenter study aimed to evaluate the impact of postoperative aspirin (ASA) use on clinical and angiographic outcomes in patients treated with the WEB device. Methods: We conducted a retrospective multicenter study across 10 academic institutions, analyzing patients with ruptured or unruptured intracranial aneurysms treated with the WEB device. Results: A total of 225 patients were included, with 163 (72.4%) receiving postoperative ASA and 62 (27.6%) in the No AP group. Before PSM, the ASA group demonstrated significantly higher rates of excellent functional outcomes (mRS 0-1: 84% vs. 70%, p = 0.031) and lower mortality (3.3% vs. 13%, p=0.014). Retreatment rates were also significantly lower in the ASA group (8.6% vs. 23%, p = 0.005). After PSM, 120 patients remained (74 ASA, 46 No AP).Retreatment rates remained significantly lower in the ASA group (5.4% vs. 24%, p=0.003), whereas the other outcomes did not reach statistical significance after matching. Conclusion: Postoperative aspirin use following WEB device treatment for intracranial aneurysms was associated with significantly lower retreatment rates, without compromising functional outcomes or mortality rates. These findings support the potential role of aspirin in enhancing aneurysm stability. Further prospective studies are needed to confirm.

UR - https://www.scopus.com/pages/publications/105036077502

U2 - 10.1017/cjn.2026.10600

DO - 10.1017/cjn.2026.10600

M3 - Article

AN - SCOPUS:105036077502

SN - 0317-1671

JO - Canadian Journal of Neurological Sciences

JF - Canadian Journal of Neurological Sciences

ER -

The Effect of Aspirin use following Woven EndoBridge Treatment: A Multicenter Study with Propensity Score-Matching

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