Treatment of unruptured distal anterior circulation aneurysms with flow diverter stents: A meta-analysis - 28/02/20
, Paolo Perrini, MD 2, Cyril Dargazanli, MD 1, Pierre-Henri Lefevre, MD 1, Gregory Gascou, MD 1, Riccardo Morganti, MD 3, Davide di Carlo, MD 2, Imad Derraz, MD 1, Carlos Riquelme, MD 1, Alain Bonafe, MD 1, Vincent Costalat, MD 1Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.
| páginas | 2 |
| Iconografías | 0 |
| Vídeos | 0 |
| Otros | 0 |
Resumen |
Background |
The safety and efficacy of FD among distal AC aneurysms must be proved.
Purpose |
To analyze the outcomes after FD among MCA, AcomA, and DACA aneurysms.
Data sources |
A systematic search of three databases was performed for studies published from 2005 to 2018.
Study selection |
According to PRISMA guidelines, we included studies reporting FD of distal AC aneurysms.
Data analysis |
Random-effects meta-analysis was used to pool aneurysm occlusion and complication rates. From the individual patient data, univariate and multivariate analysis were used to test predictors of occlusion and complications.
Data synthesis |
We included 27 studies (484 aneurysms). Long-term adequate occlusion rate (OKM C-D) was 82.7 % (295/364, 95 % CI=77.4 %–87.9 %, I2=52 %). Treatment-related complications were 12.5 % (63/410, 95 % CI=9 %–16 %%, I2=18.8 %), with 5.4 % (29/418, 95 % CI=3.2–7.5 %, I2=0 %) of morbidity. MCA location was an independent factor associated with lower occlusion (OR=0.5, P=0.03) and higher complication rates (OR=1.8, P=0.02), compared to AcomA and DACA aneurysms. PED (vs other stents) gave better occlusion rates (OR=2.6, P=0.002), whereas large/giant aneurysms were associated with higher odds of complications (OR=2.2, P=0.03). The rates of occlusion and narrowing of arteries covered by flow-diverter stents were 6.3 % (29/283, 95 % CI=3.5 %–9.1 %, I2=4.2 %) and 23.8 % (69/283, 95 % CI=15.7 %–32 %, I2=80 %), respectively. Symptoms related to occlusion and narrowing of the jailed arteries were 3.5 % (6/269, 95 % CI=1.1 %–5 %, I2=0 %) and 3 % (6/245, 95 % CI=1 %–4 %, I2=0 %), respectively.
Limitations |
Small and retrospective series.
Conclusions |
FD among distal AC aneurysms is effective, leading to adequate aneurysm occlusion in 83 % of cases. However, this strategy presents some limitations among MCA, and for larger lesions especially related to the higher rate of complications. Compared to the other devices, PED seems to be associated with a higher occlusion rate.
El texto completo de este artículo está disponible en PDF.Esquema
Vol 47 - N° 2
P. 101-102 - mars 2020 Regresar al número
Artículo precedente
- Intérêt du mismatch clinicoradiologique dans l’indication de la thrombolyse intra-veineuse dans l’AVCI
- C. Kora, S. El Arabi, H. Abdelouahhab, F. Aidid, S. Nasri, F. Aziouaz, Y. Mebrouk, I. Kamaoui, I. Skiker
- Mechanical thrombectomy in patients with acute ischemic stroke and ASPECTS ? 6: A meta-analysis
- Federico Cagnazzo, Imad Derraz, Cyril Dargazanli, Pierre-Henri Lefevre, Gregory Gascou, Carlos Riquelme, Alain Bonafe, Vincent Costalat
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
La compra de artículos no está disponible en este momento.
¿Ya suscrito a @@106933@@ revista ?