The efficacy and safety of flow-diverting device and coil embolization for intracranial aneurysms: a meta-analysis.

ABSTRACT

OBJECTIVE: To compare the clinical efficacy and safety of flow-diverting device (FDD) and coil embolization therapy (CET) in the treatment of intracranial aneurysms through a meta-analysis. MATERIALS AND METHODS: We comprehensively searched in PubMed, Embase, Cochrane Library, CNKI, Wan Fang, VIP databases, and China Biology Medicine disc (CBM) for eligible literature. Odds ratio (SMD) and 95% confidence intervals (CIs) were considered as effect measures. Statistical heterogeneity was tested by Cochran's Q statistic and I2 tests, and sensitivity analysis was used to evaluate the stability of research results. Publication bias was detected by funnel diagrams. RESULTS: A total of 888 patients from 9 studies were finally enrolled in our analysis. Through meta-analysis, the results showed that the aneurysm occlusion rate in the FDD group was significantly higher than that in the CET group (OR, 95% CI=1.68, 1.20 to 2.36, p=0.002), and the retreatment rate after aneurysm operation in the FDD group was significantly lower than that in the FDD group (OR, 95% CI=0.40, 0.22 to 0.74, p=0.003). There was no significant difference in the proportion of mRS score (0-2) between the two groups during postoperative follow-up (OR, 95% CI=0.63, 0.20 to 1.94, p=0.43). In terms of safety, there was no significant difference in the incidence of postoperative complications (OR, 95% CI=1.11, 0.68 to 1.81, p=0.67) and mortality (OR, 95% CI=1.35, 0.53 to 3.42) between the two groups. CONCLUSIONS: Compared with CET, FDD has achieved satisfactory results in increasing the rate of aneurysm occlusion and reducing the rate of retreatment of intracranial aneurysms. There is no significant difference in security between FDD and CET, though. These findings are reported in this paper, but because of the limitations of the included study, they need to be further verified by well-designed multicenter randomized controlled trials (RCT).