Effectiveness, Safety and Risk Factors of Woven EndoBridge Device in the Treatment of Wide-Neck Intracranial Aneurysms: Systematic Review and Meta-Analysis
| Autor: | Jia Miao, Lun-Xin Liu, Peng-Wei Ren, Su-Ming Zhang, Xiao-Dong Xie |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Ovid medline Wide neck business.industry Endovascular Procedures Intracranial Aneurysm Odds ratio Embolization Therapeutic Confidence interval Surgery 03 medical and health sciences Treatment Outcome 0302 clinical medicine Data extraction Risk Factors 030220 oncology & carcinogenesis Meta-analysis Occlusion medicine Humans Neurology (clinical) Complication business 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 136:e1-e23 |
| ISSN: | 1878-8750 |
| Popis: | Objective To assess the current efficacy, safety, and risk factors of the Woven EndoBridge (WEB) in treating wide-neck intracranial aneurysms. Data Source We searched the PubMed, Ovid MEDLINE, and EMBASE databases between December 1, 2012 and June 30, 2018. Study Selection Studies that included five or more patients undergoing WEB for wide-neck intracranial aneurysms, reported an angiographic or clinical outcome and risk factors, and were published after December 1, 2012 were eligible. Data Extraction And Synthesis Major outcomes included initial or short-term complete and adequate occlusion. Secondary outcomes included treatment failure, recanalization, mortality, morbidity, and complication (e.g., thromboembolism or intraoperative rupture) rates. A random effect model was used to pool the data. To assess risk factors for short-term angiographic outcomes and the most common complications, we conducted subgroup analyses and obtained odds ratios with 95% confidence intervals. Results We included 36 studies (1759 patients with 1749 aneurysms). The initial complete and adequate occlusion rates were 35% and 77%, respectively. After a mean follow-up of 9.34 months, the short-term complete and adequate occlusion rates were 53% and 80%, respectively. Thromboembolism and recanalization were the most common complications (both 9%), followed by mortality (7%), morbidity (6%), failure (5%) and intraoperative rupture (3%). The following factors were related to higher short-term obliteration rates: unruptured status, in the anterior circulation, a medium neck (4-9.9 mm), newer-generation WEB and treatment without additional devices. Ruptured status, anterior circulation, preoperative antiplatelet therapy and newer-generation WEB were not significantly related withto thromboembolism. Conclusion WEB has a satisfactory safety profile and shows promising efficacy in treating wide-neck intracranial aneurysms. We preliminarily identified several risk factors for short-term angiographic outcomes. |
| Databáze: | OpenAIRE |
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