scholarly journals Flow-diverter devices in the treatment of intracranial aneurysms: A meta-analysis and systematic review

2016 ◽  
Vol 29 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Xianli Lv ◽  
Hongchao Yang ◽  
Peng Liu ◽  
Youxiang Li
Author(s):  
William A Florez ◽  
Ezequiel Garcia-Ballestas ◽  
Gabriel Alexander Quiñones-Ossa ◽  
Tariq Janjua ◽  
Subhas Konar ◽  
...  

Flow diverters have become a critical instrument for complex aneurysms treatment. However, limited data are currently available regarding short and long-term outcomes for the Silk flow diverter. The objective of the study is to determine neurological prognosis and mortality rates for the Silk flow diversion device used in intracranial aneurysms. A systematic review with meta-analysis was performed using databases. The following descriptors were used for the search: “SILK”, “Flow Diverter”, “Mortality”, and “Prognosis”. The following data were extracted: mortality, good functional outcome, Glasgow outcome scale, complete or near-complete occlusion rates, rate of retreatment, and complications (thromboembolic and hemorrhagic complications). A total of 14 studies were selected. Among the 14 studies, 13 were retrospective observational cohort studies and 1 was a prospective observational cohort study. The mortality rate was 2.84%. The clinical good outcomes rate was 93.3%. The poor outcome rate was 6.6%. The overall thromboembolic complication rate was 6.06% (95% confidence interval [CI] 0.00–6.37, P=0.12, I<sup>2</sup>=3.13%). The total hemorrhagic complication rate was 1.62% (95% CI 0.00–5.34, P=0.28, I<sup>2</sup>=1.56%). The complete aneurysm occlusion rate was 80.4% (95% CI 8.65–9.38, P<0.0001, I<sup>2</sup>=9.09%). The Silk diverter device has a good safety and efficacy profile for treating intracranial aneurysms with high complete occlusion rates.


2018 ◽  
Vol 39 (9) ◽  
pp. 1669-1675 ◽  
Author(s):  
F. Cagnazzo ◽  
D.T. di Carlo ◽  
M. Cappucci ◽  
P.-H. Lefevre ◽  
V. Costalat ◽  
...  

2018 ◽  
Author(s):  
Alexander F. Hulsbergen ◽  
Lida Mirzaei ◽  
Arthur T. Van der Boog ◽  
Timothy R. Smith ◽  
Ivo S. Muskens ◽  
...  

2017 ◽  
Vol 38 (12) ◽  
pp. 2289-2294 ◽  
Author(s):  
F. Cagnazzo ◽  
D. Mantilla ◽  
P.-H. Lefevre ◽  
C. Dargazanli ◽  
G. Gascou ◽  
...  

2021 ◽  
pp. 159101992110279
Author(s):  
Muhammad Waqas ◽  
Rimal H Dossani ◽  
Modhi Alkhaldi ◽  
Jocelyn Neveu ◽  
Justin M Cappuzzo ◽  
...  

Introduction The Flow Redirection Endoluminal Device (FRED; MicroVention) is a dual-layered flow diverter used for the treatment of intracranial aneurysms. The objective of this systematic review was to compile device-related safety and effectiveness data. Methods The literature from January 1, 2013 to April 30, 2021 was searched for studies describing use of the FRED for intracranial aneurysm treatment irrespective of aneurysm location and morphology. The review included anterior and posterior circulation ruptured and unruptured saccular, fusiform or dissection, and blister aneurysms. MeSH terms related to “flow re-direction endoluminal device” and “FRED for aneurysms” were used. Data related to indication, complications, and rates of aneurysm occlusion were retrieved and analyzed. Results Twenty-two studies with 1729 intracranial aneurysms were included in this review. Overall reported morbidity was 3.9% (range 0–20%). Overall procedure-related mortality was 1.4% (range 0–6%). Complication rates fell into 5 categories: technical (3.6%), ischemic (3.8%), thrombotic or stenotic (6%), hemorrhagic (1.5%), and non-neurological (0.8%). The aneurysm occlusion rate between 0 and 3 months (reported in 11 studies) was 47.8%. The occlusion rate between 4 and 6 months (reported in 14 studies) was 73.8%. Occlusion rates continued to increase to 75.1% at 7–12 months (reported in 10 studies) and 86.6% for follow-up beyond 1 year (reported in 10 studies). Conclusion This review indicated that the FRED is a safe and effective for the treatment of intracranial aneurysms. Future studies should directly compare the FRED with other flow diverters for a better understanding of comparative safety and effectiveness among the different devices.


2018 ◽  
Vol 39 (11) ◽  
pp. 2064-2069 ◽  
Author(s):  
F. Cagnazzo ◽  
M. Cappucci ◽  
P.-H. Lefevre ◽  
C. Dargazanli ◽  
G. Gascou ◽  
...  

Author(s):  
João Paulo Mota Telles ◽  
Davi Jorge Fontoura Solla ◽  
Vitor Nagai Yamaki ◽  
Nicollas Nunes Rabelo ◽  
Saul Almeida da Silva ◽  
...  

Author(s):  
C Dandurand ◽  
H Parhar ◽  
F Naji ◽  
S Prakash ◽  
PA Gooderham

Background: Headaches are a major cause of disability and healthcare cost worldwide. When investigating headaches etiology, incidental unruptured intracranial aneurysms are often considered unrelated. We conducted a systematic review and meta-analysis to assess headaches outcomes (severity) after treatment of unruptured intracranial aneurysm. Methods: MEDLINE and EMBASE were systematically reviewed. Results: The data from eligible studies (n=7) was extracted and analyzed. 309 nonduplicated patients provided patient-level data for analysis. All studies used the 10-point numeric rating scale (NRS). 88% of patients were treated with endovascular technique. Overall, the observed effect estimate under a random effects model was found to be a standard mean difference in pre- and post-intervention headache severity of -0.448 (95% CI: -0.566 to -0.329). No significant heterogeneity was noted. No significant publication bias was demonstrated. Conclusions: This is the first and largest systematic review assessing postoperative headache outcomes after treatment of unruptured intracranial aneurysm. A significant reduction in headache intensity after treatment is observed in the current published literature. This study highlights an interesting clinical phenomenon that still warrants scientific effort before it can influence clinical practice. We encourage future study to stratify headache outcomes by aneurysm size, location and treatment modality.


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