Safety and efficacy of endovascular treatment for intracranial infectious aneurysms: A systematic review and meta-analysis.
J Neuroradiol
; 43(5): 309-16, 2016 Oct.
Article
en En
| MEDLINE
| ID: mdl-27137085
ABSTRACT
INTRODUCTION:
Intracranial infectious aneurysms (IIAs), or mycotic aneurysms are rare, representing between 0.7% and 5.4% of all intracranial aneurysms. To clarify the safety and efficacy of endovascular treatment of IIAs, we conducted a systematic review of the literature analyzing periprocedural and long-term clinical and angiographic outcomes.METHODS:
A comprehensive review of the literature for studies with ≥3 patients related to endovascular treatment of IIAs published through September 2015 was performed. Random-effects meta-analysis was used to pool the followingoutcomes:
complete occlusion, technical success, aneurysm recurrence, rebleeding, perioperative mortality, iatrogenic rupture, perioperative stroke, procedure-related morbidity and mortality, long-term neurological morbidity and mortality, and overall good neurological outcome.RESULTS:
We included 11 non-comparative studies with 86 target IIAs. Complete occlusion rates were 95.3% (95% CI=91.2-99.4%). Recurrence occurred in 7.9% (95% CI=2.7-13.0%). Rebleeding occurred in 5.8% (95% CI=1.4-10.3%) of patients. Procedure-related morbidity was 12.6% (95% CI=6.1-19.2%) and procedure-related mortality was 6.1% (95% CI=1.5-10.8%). Long-term good neurological outcome was 68.0% (95% CI=55.1-80.9%).CONCLUSION:
Our meta-analysis demonstrated that endovascular treatment is technically feasible and effective with high rates of IIA occlusion. Despite the comorbidities of patients, endovascular approach was associated with acceptable rates of procedure-related morbidity and satisfactory rates of overall good neurological outcome.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Aneurisma Intracraneal
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Procedimientos Endovasculares
Tipo de estudio:
Systematic_reviews
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2016
Tipo del documento:
Article