Abstract Details

Title Transradial Versus Transfemoral Access for Woven EndoBridge (WEB) Embolization of Intracranial Aneurysms: A Propensity-Score Matched Multicenter Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 077

Objective

This study aimed to compare the technical and clinical outcomes between the transradial access (TRA) and transfemoral access (TFA) for WEB embolization of intracranial aneurysms.

Background TRA has become commonly utilized in neurointerventional procedures. Currently, only few case reports and small case series have attempted to investigate the efficacy and safety of TRA for WEB embolization for intracranial aneurysms.

Design/Methods This is a secondary analysis of the WorldwideWEB Consortium, which comprises multicenter data related to adult patients with intracranial aneurysms treated with the WEB device. These aneurysms were categorized into two groups: TRA and TFA. Patients and aneurysms characteristics, and technical and clinical outcomes were compared between the two groups. Propensity score matching (PSM) was used to match by the following covariates: age, gender, bifurcation location, incorporated branch, neck width, aspect ratio, dome width, adjunctive coiling, and last follow up imaging elapsed time.

Results This study included 682 intracranial aneurysms (median [IQR] age: 61.3 [53.0, 68.0] years); 561 of whom were treated using the TFA, while 121 were treated using the TRA. PSM resulted in 61 matched pairs. Following PSM, both groups had similar characteristics, angiographic and functional outcome, retreatment, thromboembolic and hemorrhagic complications, and mortality. The TFA was associated with a longer length of procedure (min) (94.0 vs. 72.0, p=0.012) and fluoroscopy time (min) (28.9 vs. 24.1, p=0.034) as compared to the TRA. On the other hand, TRA was associated with a higher rate of deployment issues, but none of them resulted in permanent complications.

Conclusions TRA is associated with comparable outcomes, with shorter procedure and fluoroscopy time compared to TFA for aneurysm treatment with the WEB device.

Authors/Disclosures
Mahmoud Dibas, MD PRESENTER	Mr. Dibas has nothing to disclose.
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Jose Danilo B. Diestro, MD (St. Michael's Hospital, University of Toronto)	Dr. Diestro has nothing to disclose.
Hugo Cuellar-Saenz	No disclosure on file
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Robert W. Regenhardt, MD, PhD	Dr. Regenhardt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genomadix. Dr. Regenhardt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Rapid Medical. Dr. Regenhardt has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Johnson and Bell Trial Lawyers. Dr. Regenhardt has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Buckley, Theroux, Kline, & Cooley Trial Lawyers. The institution of Dr. Regenhardt has received research support from National Institutes of Health. The institution of Dr. Regenhardt has received research support from Society of Vascular and Interventional Neurology. The institution of Dr. Regenhardt has received research support from Heitman Foundation.
Justin Vranic (Massachusetts General Hospital)	No disclosure on file
Ivan Lylyk	No disclosure on file
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Muhammad Ubaid Hafeez, MD (University of Texas Medical Branch)	Dr. Hafeez has nothing to disclose.
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James Rabinov	James Rabinov has nothing to disclose.
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Anna Luisa Kühn (UMass Memorial Medical Center)	No disclosure on file
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Robert Starke	Robert Starke has nothing to disclose.
Ameer Hassan, DO (Valley Baptist Medical Center)	Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Penumbra. Dr. Hassan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cerenovus. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Viz.ai. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Hassan has received research support from GE Healthcare.
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Ajit Puri	No disclosure on file
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Christopher Stapleton (Massachusetts General Hospital)	Christopher Stapleton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Johnson & Johnson MedTech. Christopher Stapleton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll Circulation, Inc.. Christopher Stapleton has received publishing royalties from a publication relating to health care.
Adnan Siddiqui	Adnan Siddiqui has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott Laboratories, Acandis, Asahi Intecc Co. Ltd., Canon Medical Systems USA, Inc., Carotix Medical, LLC, CerebrovaKP, Cerenovus, Contego Medical, Inc., Cordis, Endostream Medical, Ltd (recently sold to Kaneka), FreeOx Biotech, SL, Hyperfine Operations, Inc., Imperative Care , InspireMD, Ltd., IRRAS AB, Medtronic, Minnetronix Neuro, Inc., MMI, Peijia Medical, Penumbra, Inc. Perflow Medical, Ltd., Piraeus Medical, Inc., Prometheus Therapeutics, Inc., Q'Apel Medical, Inc., Serenity Medical, Inc., Shockwave Medical, Inc., Stryker Neurovascular., Synchron Australia Pty Ltd., Tegus Medical, GmbH, T.G. Medical, Inc., Terumo Neuro (Formerly MicroVention), Unity Medical, Inc. Vastrax, LLC, Vesalio, Viz.ai, Inc., WL Gore. Adnan Siddiqui has stock in 3N Endovascular, Adona Medical, Inc., Basecamp Vascular SAS, Bend IT Technologies, Ltd., BlinkTBI, Inc, Borvo Medical, Inc., CerebrovaKP, Code Zero Medical, Inc., Cognition Medical, Collavidence, Inc., Contego Medical, Inc., CVAID Ltd., CygnusMed, E8, Inc., Endostream Medical, Ltd (Sold 2025 to Kaneka), FreeOx Biotech, SL, Galaxy Therapeutics, Inc., Hyperion Surgical, Inc., Imperative Care, Inc., InspireMD, Ltd., Instylla, Inc., IRRAS, AB, Launch NY, Inc., Neurolutions, Inc., Neurovascular Diagnostics, Inc., NeXtGen Biologics, Peijia Medical, PerFlow Medical, Ltd., Physician X, LLC, Piraeus Medical, Inc., Prometheus Therapeutics, Inc., PUMA Venture Capital Fund I, LP, Q'Apel Medical, Inc., QAS.ai, Inc., Radical Catheter Technologies, Inc., ReNiva, Inc., Rist Neurovascular, Inc. (Purchased 2020 by Medtronic), Sense Diagnostics, Inc., Serenity Medical, Inc., Silk Road Medical, Sim & Cure, Spinnaker Medical, Inc., Stent'Up, Synchron, Inc., Tegus Medical, GmbH, T.G. Medical, Inc., Tulavi Therapeutics, Inc., Vastrax, LLC,, Viseon, Inc., Viz.ai, Whisper Medical, Inc., Willow Medtech, Inc. . Adnan Siddiqui has received research support from National PI/Steering Committees: Cerenovus EXCELLENT and ARISE II Trial; Medtronic ARTISSE IDE, SWIFT PRIME, VANTAGE, EMBOLISE and SWIFT DIRECT Trials; Terumo Neuro (formerly MicroVention) FRED Trial & CONFIDENCE Study; MUSC POSITIVE Trial; Penumbra 3D Separator Trial, COMPASS Trial, INVEST Trial, MIVI neuroscience EVAQ Trial; Rapid Medical SUCCESS Trial; InspireMD C-GUARDIANS IDE Pivotal Trial; . The institution of Adnan Siddiqui has received research support from Current Research Grants: Co-I for NSF 2304388 STTR Phase II: An AI-Enhanced Angiographic System to Guide Endovascular Treatment of Intracranial Aneurysms; Co-PI NIH OT2NS129366 / Medical University of South Carolina StrokeNet Thrombectomy Endovascular Platform (STEP); PI for Brain Aneurysm Foundation study titled Exploring the Relationship between Imaging- and Blood-Based Aneurysm Biomarkers and the Pathobiology of the Aneurysm Wall; PI for University of Cincinnati / NINDS FASTEST: rFVIIa for Acute Hemorrhagic Stroke Administered at Earliest Time Trial;. Adnan Siddiqui has received intellectual property interests from a discovery or technology relating to health care.
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Peter Kan	No disclosure on file
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Pedro Lylyk	No disclosure on file
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Aman Patel	Aman Patel has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Microvention. Aman Patel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Aman Patel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Aman Patel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Penumbra.
Adam Dmytriw (Massachusetts General Hospital)	Adam Dmytriw has nothing to disclose.

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