{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:12:01Z","timestamp":1793725921084,"version":"4.6.1"},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The Woven EndoBridge (WEB) device was approved to treat wide-necked bifurcation aneurysms. The device is designed as an intrasaccular flow disruptor covering aneurysm widths up to 10 mm. Although prior studies combined all aneurysm sizes, it is known that aneurysms behave differently in response to endovascular treatment based on their size. Therefore, the authors\u2019 objective was to identify ideal middle cerebral artery (MCA) aneurysm width and neck sizes most suitable for WEB treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The WorldWideWEB consortium is a large multicenter retrospective database that analyzes intracranial aneurysms treated with the WEB device. In this study, all unruptured MCA bifurcation aneurysms with available measurements were included. Cutoff values based on aneurysm width and neck in relation to aneurysm occlusion status were measured using the receiver operating characteristic (ROC) curve. Propensity score matching (PSM) was then used to compare treatment outcomes between aneurysms smaller and larger than the cutoff value for both width and neck size.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The ideal cutoff values for MCA bifurcation aneurysm width and neck were 6.1 mm and 4.6 mm, respectively. On PSM, 87 matched pairs were compared based on width size (\u2264 6.1 mm and &gt; 6.1 mm), and 77 matched pairs were compared based on neck size (\u2264 4.6 mm and &gt; 4.6 mm). There was a significant difference in adequate aneurysm occlusion between aneurysms smaller and larger than those cutoff values for both widths (93% vs 76%, p = 0.0017) and neck sizes (90% vs 70%, p = 0.0026). The retreatment rate was also significantly higher for larger aneurysms in both parameters.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>This study shows that MCA bifurcation aneurysms \u2264 6.1 mm in width and \u2264 4.6 mm in neck size are significantly better candidates for WEB treatment, leading to improved occlusion status and reduced retreatment rate, which are important considerations when using WEB devices.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.5.jns232204","type":"journal-article","created":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T01:29:36Z","timestamp":1728696576000},"page":"1-11","source":"Crossref","is-referenced-by-count":4,"title":["Defining ideal middle cerebral artery bifurcation aneurysm size for Woven EndoBridge embolization"],"prefix":"10.3171","author":[{"given":"Nimer","family":"Adeeb","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basel","family":"Musmar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza Adel","family":"Salim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assala","family":"Aslan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika","family":"Alla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M.","family":"Cancelliere","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Diagnostic and Therapeutic Neuroradiology, St. Michael\u2019s Hospital, University of Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M.","family":"McLellan","sequence":"additional","affiliation":[{"name":"Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women\u2019s Hospital, Harvard University, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oktay","family":"Algin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty, Y\u0131ld\u0131r\u0131m Beyazit University, Ankara, Turkey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherief","family":"Ghozy","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Dibas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sovann V.","family":"Lay","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Therapeutic Neuroradiology, Toulouse Hospital Center, Purpan Hospital, Toulouse, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrien","family":"Guenego","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Erasme University Hospital, Brussels, 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