Treatment of posterior circulation non- saccular aneurysms with flow diversion versus stent- assisted coiling: a systematic review and meta- analysis.

Autor: Domingo, Ricardo A., Tripathi, Shashwat, Vega, Carlos Perez, Buitrago, Tito Vivas, Lu, Victor M., Todnem, Nathan D., Hinojosa, Alfredo Quinones, Tawk, Rabih G.
Předmět:
Zdroj: Journal of NeuroInterventional Surgery; Feb2021, Vol. 13 Issue 2, p159-163, 6p
Abstrakt: Treatment of non- saccular aneurysms of the posterior circulation poses a great challenge with unpredictable outcomes due to the absence of a true aneurysm neck and the presence of perforating vessels. In this article, we aim to compare endovascular treatment of unruptured posterior circulation non- saccular aneurysms with stentassisted coiling (SAC) and flow diversion (FD) in terms of occlusion rate and clinical outcomes. A systematic search of electronic databases from inception to August 2019 identified 484 articles for screening. After proper inclusion/exclusion criteria, 15 articles were included and data were extracted and analyzed using metaanalysis of proportions. The pooled cohort consisted of 430 aneurysms: 128 (29.7%) treated with SAC in 5 studies and 302 (70.3%) treated with FD in 11 studies. Complete/near- complete occlusion was achieved in 83% after FD (95% CI 0.75 to 0.90; I2=45%) and 84% after SAC (95% CI 0.72 to 0.91; I2=22%), with no significant difference between techniques (p=0.95). Periprocedural complications were observed in 18% after FD (95% CI 0.14 to 0.23; I2=0%) and 6% after SAC (95% CI 0.02 to 0.13; I2=0%); the subgroup analysis was statistically significant (p=0.008). Furthermore, no statistically significant difference was observed in favorable clinical outcomes between groups. These results suggest similar efficacy in occlusion rate and favorable clinical outcome for posterior circulation non- saccular aneurysms treated with SAC and FD. Stroke was the most common complication regardless of treatment modality, and a lower periprocedural complication rate was noted with SAC. Further studies are needed with the primary focus of reducing the risk of stroke with either modality. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index