Patency of the supraclinoid internal carotid artery branches after flow diversion treatment. A meta-analysis - 21/01/19
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Abstract |
Background and purpose |
Placement of flow-diverters across the ostia of major ICA branches carries a risk of arterial occlusion. We determined the rate of occlusion of the supraclinoid ICA branches and the related symptoms, following coverage with flow-diverters.
Materials and methods |
A systematic search was performed in PubMed, MEDLINE, and EMBASE. We selected studies reporting treatments with flow-diverters in which the device was placed across the ostium of the OphtA, PcomA, or AchorA. Random-effects meta-analysis was used to pool the following outcomes: rate of arterial occlusion, diminished flow, incidence of related symptoms, factors associated with arterial occlusion.
Result |
Twenty-one studies evaluating 1152 supraclinoid ICA branches were included in the meta-analysis. The incidence of OphtA occlusion and associated symptoms was 5.9% (95 CI% = 3.1–8.6%) (incidence rate = 6% per patient-year), and 0.8% (95% CI = 0.1–1.4%) (incidence rate = 0.8% per patient-year), respectively. Although asymptomatic in all cases, PcomA showed a higher occlusion rate (20.7%, 95% CI = 8.9–32.4%) (incidence rate = 19.5% per patient-year). AchorA was occluded in 1% (95% CI = 0.3–2.4%) of cases, with approximately 1% (95% CI = 0.4–2.3%) of transient neurological symptoms (incidence rate = 0.96% per patient-year). There was a trend toward higher odds of arterial patency among arteries arising from the aneurysm (OR = 2.94, P = 0.06). Demographic factors and multiple stents were not associated with higher risk of arterial impairment. Adequate collateral circulation was reported in 94.5% of patients with arterial occlusion.
Conclusions |
During aneurysm treatment, the ostium of the supraclinoid ICA branches can be covered with flow-diverter devices with low rates of neurological symptoms related to arterial occlusion.
El texto completo de este artículo está disponible en PDF.Keywords : Flow diversion, Intracranial aneurysms, Pipeline, Endovascular treatment, Patency, Side branches occlusion
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Vol 46 - N° 1
P. 9-14 - février 2019 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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