Basel Musmar, Hamza Salim, Joanna M. Roy, N Adeeb, Antony A. Fuleihan, E Atallah, Bachar El Baba, Brian M. Howard, Jonathan A. Grossberg, Kyle W. Scott, Jan-Karl Burkhardt, Visish M. Srinivasan, Fernanda Erazu, Eric Sauvageau, Amin Aghaebrahim, Ricardo A. Hanel, Abdelaziz Amllay, Charles Matouk, Andrew MacNeil, Nohra Chalouhi, Matthew Koch, Santiago Gomez-Paz, Ramesh Grandhi, Vinay Jaikumar, Elad Levy, Adnan Siddiqui, Yasha Kayan, Alexander Copelan, Josser E Delgado Almandoz, Haydn Hoffman, Adam Arthur, David M. Hasan, Christina Notarianni, Hugo H Cuellar, Bharat Guthikonda, Jacques Morcos, Stavropoula Tjoumakaris, Michael Reid Gooch, Robert H. Rosenwasser, Pascal Jabbour
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.