RT Journal Article
SR Electronic
T1 Persistent Opacification of the Woven EndoBridge Device: A Conebeam CT Analysis of the Bicêtre Occlusion Scale Score 1 Phenomenon
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A7783
A1 Caroff, J.
A1 Popescu, S.D.
A1 Mihalea, C.
A1 Popica, D.A.
A1 Ikka, L.
A1 Gallas, S.
A1 Ozanne, A.
A1 Chalumeau, V.
A1 Moret, J.
A1 Cortese, J.
A1 Spelle, L.
YR 2023
UL http://www.ajnr.org/content/early/2023/02/09/ajnr.A7783.abstract
AB BACKGROUND AND PURPOSE: Some Woven EndoBridge devices present a persistent intradevice opacification at imaging follow-up, described as the Bicêtre Occlusion Scale Score 1 (BOSS 1) phenomenon. The clinical implications remain unknown. We aimed here to analyze the factors influencing this occurrence and to precisely describe the evolution of BOSS 1 with time using conebeam CT.MATERIALS AND METHODS: We retrospectively analyzed a prospectively maintained Woven EndoBridge database at our tertiary center and included all patients with isolated BOSS 1 and BOSS 1 associated with small neck remnant (BOSS 1 + 2).RESULTS: Two hundred sixty-seven aneurysms were treated with a Woven EndoBridge device between July 2012 and December 2021. Follow-up with DSA was available for 220 aneurysms (median, 5 months), among which BOSS 1 and 1 + 2 were found in 9.1% (20/220) (95% CI, 5.5%—12.7%). A second DSA follow-up (median, 17 months) was performed in 15 of these 20 aneurysms, which revealed that 40% had evolved to complete Woven EndoBridge occlusion, 33% showed a decreased persistent opacification, and 27% remained stable. BOSS 1 was significantly associated with postoperative antiplatelet medication, a lower aneurysm aspect ratio, and the use of the Woven EndoBridge 17 (P < .05). The average Woven EndoBridge shape modification was less pronounced in the BOSS 1 population (P < .02). None of the BOSS 1 or 1 + 2 aneurysms required retreatment or were associated with hemorrhage occurrence.CONCLUSIONS: Isolated persistent flow inside the Woven EndoBridge device at follow-up is rare and notably associated with antiplatelet prescription. It seems to present a benign course in most cases.BOSS 1Bicêtre Occlusion Scale Score 1CBCTconebeam CTFUfollow-upWShMWEB shape modificationWEBWoven EndoBridge