Endovascular Coiling of Ruptured Tiny Saccular Intracranial Aneurysms: A Systematic Review and Meta-Analysis.
World Neurosurg
; 187: e414-e446, 2024 Jul.
Article
en En
| MEDLINE
| ID: mdl-38663736
ABSTRACT
BACKGROUND:
The safety and efficacy of endovascular coiling of ruptured tiny saccular intracranial aneurysms (IAs) (≤3 mm) remain unknown.METHODS:
A comprehensive search of PubMed, Embase, Web of Science, and Scorpus databases up to November 15, 2023 was performed. Pooled prevalence was calculated for occlusion rates, recanalization, retreatment, long-term favorable outcome, and procedure-related complications and mortality. Pooled odds ratios were calculated to compare these outcomes between coiling and stent-assisted coiling (SAC).RESULTS:
Forty-two studies with 2166 ruptured tiny saccular IAs treated with coiling were included. The follow-up complete aneurysm occlusion rate was 83.9% (95% CI 77.2-88.9%). The rates of recanalization and retreatment were 7.7% (95% CI 5.7-10.2%) and 5.8% (95% CI 4.5-7.5%). The range of median Hunt and Hess grades was 1.4-2.9 and the favorable outcome rate was 85.6% (95% CI 81.1-89.2%). The rates of thromboembolism, intraprocedural rupture, and mortality were 4.6% (95% CI 3.6-5.8%), 5.4% (95% CI 4.1-7.0%), and 5.6% (95% CI 4.4-7.2%), respectively. Comparison of coiling and SAC revealed no significant difference, except for a higher likelihood of follow-up complete aneurysm occlusion in SAC (odds ratio [OR] 0.37, 95% CI 0.17-0.80) and recanalization in the coiling (OR, 3.21 [95% CI, 1.37-7.51]).CONCLUSIONS:
Our meta-analysis demonstrates that coiling for ruptured tiny saccular IA is a feasible, effective, and safe approach that is associated with favorable clinical outcomes in both the short and long term for patients with mild to moderate Hunt and Hess grades.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Aneurisma Intracraneal
/
Aneurisma Roto
/
Procedimientos Endovasculares
Límite:
Humans
Idioma:
En
Revista:
World Neurosurg
Asunto de la revista:
NEUROCIRURGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Japón