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The Effect of Aspirin Use Following Woven EndoBridge Treatment: A Multicenter Study with Propensity Score Matching

Published online by Cambridge University Press:  13 April 2026

Basel Musmar ,
Hamza Adel Salim ,
Joanna M. Roy ,
Nimer Adeeb ,
Antony A. Fuleihan ,
Elias Atallah ,
Bachar El Baba ,
Brian M. Howard ,
Jonathan A. Grossberg  and
Kyle W. Scott
...Show all authors
Basel Musmar
Affiliation:
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Hamza Adel Salim
Affiliation:
MD Anderson Division of Radiology, USA
Joanna M. Roy
Affiliation:
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Nimer Adeeb
Affiliation:
Department of Neurosurgery, Louisiana State University Health Science Center, Shreveport, LA, USA
Antony A. Fuleihan
Affiliation:
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Elias Atallah
Affiliation:
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Bachar El Baba
Affiliation:
Department of Neurosurgery, Emory University, Atlanta, GA, USA
Brian M. Howard
Affiliation:
Department of Neurosurgery, Emory University, Atlanta, GA, USA
Jonathan A. Grossberg
Affiliation:
Department of Neurosurgery, Emory University, Atlanta, GA, USA
Kyle W. Scott
Affiliation:
Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, PA, USA
Jan-Karl Burkhardt
Affiliation:
Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, PA, USA
Visish M. Srinivasan
Affiliation:
Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, PA, USA
Fernanda Erazu
Affiliation:
Lyerly Neurosurgery, Baptist Health System, Jacksonville, FL, USA
Eric Sauvageau
Affiliation:
Lyerly Neurosurgery, Baptist Health System, Jacksonville, FL, USA
Amin Aghaebrahim
Affiliation:
Lyerly Neurosurgery, Baptist Health System, Jacksonville, FL, USA
Ricardo A. Hanel
Affiliation:
Lyerly Neurosurgery, Baptist Health System, Jacksonville, FL, USA
Abdelaziz Amllay
Affiliation:
Department of Neurosurgery, Yale University, New Haven, CT, USA
Charles C. Matouk
Affiliation:
Department of Neurosurgery, Yale University, New Haven, CT, USA
Andrew MacNeil
Affiliation:
Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL, USA
Nohra Chalouhi
Affiliation:
Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL, USA
Matthew Koch
Affiliation:
Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL, USA
Santiago Gomez-Paz
Affiliation:
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA
Ramesh Grandhi
Affiliation:
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA
Vinay Jaikumar
Affiliation:
Department of Neurosurgery, University of New York at Buffalo, Buffalo, NY, USA
Elad Levy
Affiliation:
Department of Neurosurgery, University of New York at Buffalo, Buffalo, NY, USA
Adnan Siddiqui
Affiliation:
Department of Neurosurgery, University of New York at Buffalo, Buffalo, NY, USA
Yasha Kayan
Affiliation:
Allina Health System, USA
Alexander Z. Copelan
Affiliation:
Allina Health System, USA
Josser E. Delgado Almandoz
Affiliation:
Allina Health System, USA
Haydn Hoffman
Affiliation:
Semmes-Murphey Neurologic and Spine Institute, USA
Adam Arthur
Affiliation:
Semmes-Murphey Neurologic and Spine Institute, USA
David M. Hasan
Affiliation:
Department of Neurosurgery, Duke University, Durham, NC, USA
Christina Notarianni
Affiliation:
Department of Neurosurgery, Louisiana State University Health Science Center, Shreveport, LA, USA
Hugo H. Cuellar
Affiliation:
Department of Neurosurgery, Louisiana State University Health Science Center, Shreveport, LA, USA
Bharat Guthikonda
Affiliation:
Department of Neurosurgery, Louisiana State University Health Science Center, Shreveport, LA, USA
Jacques Morcos
Affiliation:
Department of Neurosurgery, The University of Texas Health Science Center, Houston, TX, USA
Stavropoula I. Tjoumakaris
Affiliation:
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Michael Reid Gooch
Affiliation:
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Robert H. Rosenwasser
Affiliation:
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Pascal Jabbour*
Affiliation:
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
*
Corresponding author: Pascal Jabbour; Email: pascal.jabbour@jefferson.edu
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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 antiplatelet (No AP) group. Before propensity score matching (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.

Résumé :

RÉSUMÉ :

L’effet de l’aspirine après la pose d’un dispositif Woven EndoBridge : résultats d’une étude multicentre, fondés sur l’appariement des scores de propension.

Contexte :

Le dispositif Woven EndoBridge (WEB) se présente comme un traitement prometteur des anévrismes de bifurcation à collet large. L’étude multicentre ici présentée visait à évaluer l’effet de l’utilisation postopératoire de l’aspirine (AAS) sur les résultats cliniques et angiographiques chez les patients traités par le dispositif WEB.

Méthode :

Il s’agit d’une étude multicentre, rétrospective, réalisée dans 10 établissements universitaires, dans laquelle ont été analysées des données provenant de patients traités par le dispositif WEB pour un anévrisme intracrânien, rompu ou non.

Résultats :

Au total, l’étude comptait 225 patients, dont 163 (72,4%) avaient reçu de l’AAS en phase postopératoire et 62 (27,6%) qui n’avaient pas reçu d’antiagrégant plaquettaire (groupe « sans AP » [SAP]). Avant l’appariement des scores de propension (ASP), le groupe AAS connaissait un taux significativement élevé de résultats fonctionnels excellents (échelle de Rankin modifiée (ERM) 0 1 : 84% contre [c.] 70%; p = 0,031) et de faible mortalité (3,3% c. 13%; p = 0,014). Le taux de reprise du traitement était aussi significativement faible dans le groupe AAS (8,6% c. 23%; p = 0,005). Après l’ASP, il restait 120 patients (AAS : 74; SAP : 46). Le taux de reprise du traitement était encore une fois significativement plus faible dans le groupe AAS (5,4% c. 24%; p = 0,003) que dans le groupe de comparaison. Quant aux autres résultats, ils n’ont pas atteint une valeur statistiquement significative après l’appariement.

Conclusion :

L’utilisation postopératoire de l’aspirine après la pose d’un dispositif WEB dans le traitement d’anévrismes intracrâniens a été associée à des taux de reprise de traitement significativement faibles, sans pour autant compromettre les résultats fonctionnels ou accroître le taux de mortalité. Ces résultats confirment le rôle potentiel de l’aspirine dans l’optique d’une meilleure stabilisation des anévrismes. Toutefois, les résultats restent à confirmer dans d’autres études prospectives.

Keywords

aneurysmsaspirinWoven EndoBridge

Information

Type
Original Article
Information
Canadian Journal of Neurological Sciences , First View , pp. 1 - 10
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation.

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