scholarly journals Acutely Ruptured Intracranial Aneurysms Treated with Flow-Diverter Stents: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 39 (9) ◽  
pp. 1669-1675 ◽  
Author(s):  
F. Cagnazzo ◽  
D.T. di Carlo ◽  
M. Cappucci ◽  
P.-H. Lefevre ◽  
V. Costalat ◽  
...  
Author(s):  
Muhammad Waqas ◽  
Felix Chin ◽  
Hamidreza Rajabzadeh-Oghaz ◽  
Andrew D. Gong ◽  
Hamid H. Rai ◽  
...  

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.


2020 ◽  
Vol 10 (2) ◽  
pp. 55-61
Author(s):  
Ezequiel García-Ballestas ◽  
William A Florez- Perdomo ◽  
Robert M Starke ◽  
Andrei Fernandes Joaquim ◽  
Amit Agrawal ◽  
...  

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

2021 ◽  
pp. neurintsurg-2021-017641
Author(s):  
Kemal Alpay ◽  
Tero Hinkka ◽  
Antti E Lindgren ◽  
Juha-Matti Isokangas ◽  
Rahul Raj ◽  
...  

BackgroundFlow diversion of acutely ruptured intracranial aneurysms (IAs) is controversial due to high treatment-related complication rates and a lack of supporting evidence. We present clinical and radiological results of the largest series to date.MethodsThis is a nationwide retrospective study of acutely ruptured IAs treated with flow diverters (FDs). The primary outcome was the modified Rankin Scale (mRS) score at the last available follow-up time. Secondary outcomes were treatment-related complications and the aneurysm occlusion rate.Results110 patients (64 females; mean age 55.7 years; range 12–82 years) with acutely ruptured IAs were treated with FDs between 2012 and 2020 in five centers. 70 acutely ruptured IAs (64%) were located in anterior circulation, and 47 acutely ruptured IAs (43%) were blister-like. A favorable functional outcome (mRS 0–2) was seen in 73% of patients (74/102). Treatment-related complications were seen in 45% of patients (n=49). Rebleeding was observed in 3 patients (3%). The data from radiological follow-ups were available for 80% of patients (n=88), and complete occlusion was seen in 90% of aneurysms (79/88). The data from clinical follow-ups were available for 93% of patients (n=102). The overall mortality rate was 18% (18/102).ConclusionsFD treatment yields high occlusion for acutely ruptured IAs but is associated with a high risk of complications. Considering the high mortality rate of aneurysmal subarachnoid hemorrhage, the prevention of rebleeding is crucial. Thus, FD treatment may be justified as a last resort option.


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