Influence of operator experience on the technical and clinical results of Woven EndoBridge endovascular treatment for intracranial aneurysms

The safety and efficacy of the Woven EndoBridge (WEB) device has been proven in recent multicenter trials. This study investigated whether operator experience influences WEB treatment-related outcomes. This was a retrospective analysis of a prospectively collected multicenter database. The data of a...

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Published in:Clinical neurology and neurosurgery 2021-09, Vol.208, p.106900-106900, Article 106900
Main Authors: Daubé, P., Cagnazzo, F., Barreau, X., Morganti, R., Ferreira, I., Gariel, F., Dargazanli, C., Gascou, G., Riquelme, C., Derraz, I., Berge, J., Lefevre, PH, Costalat, V., Marnat, G.
Format: Article
Language:English
Subjects:
Aged
Aneurysm
Aneurysms
Aspirin
Cardiovascular system
Catheters
Clinical Competence
Clinical trials
Embolization
Embolization, Therapeutic
Endovascular Procedures
Flow-disrupter
Hemorrhage
Humans
Intracranial aneurysm
Intracranial Aneurysm - therapy
Learning curve
Medical imaging
Middle Aged
Neurology
Occlusion
Patients
Radiation
Retrospective Studies
Software
Treatment Outcome
Variables
Veins & arteries
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Summary:The safety and efficacy of the Woven EndoBridge (WEB) device has been proven in recent multicenter trials. This study investigated whether operator experience influences WEB treatment-related outcomes. This was a retrospective analysis of a prospectively collected multicenter database. The data of all patients who underwent WEB treatment for an intracranial aneurysm from March 2014 to June 2020 in two high-volume centers were pooled. Operator experience was indexed by the number of WEB treatments performed previously. The primary endpoint was the overall complication rate. Secondary endpoints were long-term adequate (Raymond-Roy classification of 1–2.) angiographic occlusion, WEB-related complications, number of WEB not deployed, procedure duration, and radiation exposure (air kerma). Among 237 patients (mean age 59.4 +/- 11.5 years) treated with WEB (median aneurysm diameter, 5.8 mm; interquartile range 4.5–7 mm), WEB-related complications occurred in 28 patients (11.8%) and adequate long-term occlusion was achieved for 154 aneurysms (86%). The median number of WEB treatment performed previously per operator was 20 (IQR, 9-41). The overall complication rate, WEB-related complication rate and aneurysm occlusion rate were not significantly correlated with WEB operator experience. There were also no significant correlations between the WEB operator experience and the number of WEB not deployed, procedure duration or radiation exposure. There was no significant association between the number of WEB treatments previously performed per operator and any technical or clinical results after intracranial aneurysm treatment with WEB. These results imply a relatively short learning curve for this device in high-volume neurovascular centers. •Intracranial flow disrupters are increasingly used for the treatment of intracranial aneurysm, especially complex wide-neck aneurysms.•However, the learning curve of such innovative and quite recent devices has never been investigated to date.•In our multicentric retrospective study, we found no influence of operator experience on clinical and angiographic outcomes after endovascular treatment with WEB.•Our results should be handled with caution as all the procedures were performed in high-volume centers by trained and accompanied operators.
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2021.106900