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    • Impact of Smoking on Recurrence Rates among Wide-Neck Intracranial Aneurysms Treated with Woven EndoBridge: a Multicenter Retrospective Study.

    Dhrumil Vaishnav, Muhammed Amir Essibayi，Adam A Dmytriw, WorldWideWEB Consortium

    Journal of neurosurgery（2025）

    3Department of Neurosurgery | 5Department of Neuroradiology | 6Neurosurgery Department | 2Department of Radiology | 7Radiology Department | 8Department of Neuroradiology | 9Department of Neuroradiology | 10Department of Neuroradiology | 12Department of Neuroradiology | 13Department of Neurosurgery | 14Department of Neuroradiology | 15Department of Neuroradiology | 17Department of Radiology | 18Department of Neurosurgery | 19Department of Neuroradiology | 21Department of Radiology | 22Department of Neuroradiology | 23Department of Neurosurgery | 24Department of Neurosurgery | 25Department of Neurosurgery | 26Department of Neuroradiology | 27Department of Neuroradiology | 28Department of Neuroradiology | 29Department of Neuroradiology | 30Department of Neuroradiology | 31Department of Neurosurgery | 32Department of Neuroradiology | 33Department of Neurosurgery | 34Department of Neuroradiology | 36Department of Radiology

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    Abstract
    OBJECTIVE:Tobacco smoking is among the factors known to significantly augment the risk of untreated intracranial aneurysm (IA) growth and rupture. Smoking appears to have a variable effect on different endovascular treatment modalities. The impact of smoking on the safety, efficacy, and outcomes of Woven EndoBridge (WEB) device use for wide-neck IAs has not been evaluated. This study aimed to investigate the outcomes of WEB devices by smoking status. METHODS:A retrospective multicenter analysis was conducted on the data of patients from 36 sites worldwide treated with the WEB device for intracranial saccular aneurysms. Patients were stratified based on smoking status (current, former, and never smokers). The Student t-test and chi-square test were performed for continuous and categorical variables, respectively. Multivariable logistic regression was used to adjust for confounders. RESULTS:Of 1376 patients with available smoking status, 504 were current smokers, 358 were former smokers, and 514 were never smokers. Upon adjusting for significant confounders, no association was found between smoking and recurrence outcomes (OR 1.39, 95% CI 0.69-2.80; p = 0.36), thromboembolic and hemorrhagic complications, and mortality among IAs treated with the WEB device. There was no statistically significant difference in outcomes between former and never smokers (OR 1.23, 95% CI 0.70-2.18; p = 0.46). The location of aneurysms differed between smoking groups, with former smokers having more anterior circulation aneurysms compared with current and never smokers (99.0% vs 96.9% vs 95.3%; p = 0.01). In terms of clinical symptoms, headache and dizziness were more common in the never smokers compared with current and former smokers (13.9% vs 8.9% vs 7.7%, p = 0.01). CONCLUSIONS:This large-scale study suggests no significant correlation between smoking and the recurrence of IAs treated with the WEB device. Biological studies are warranted to better understand the biological impact of smoking on the growth and rupture of treated IAs.
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