Patency of the supraclinoid internal carotid artery branches after flow diversion treatment. A meta-analysis.
J Neuroradiol
; 46(1): 9-14, 2019 Feb.
Article
em En
| MEDLINE
| ID: mdl-30099016
ABSTRACT
BACKGROUND AND PURPOSE:
Placement of flow-diverters across the ostia of major ICA branches carries a risk of arterial occlusion. We determined the rate of occlusion of the supraclinoid ICA branches and the related symptoms, following coverage with flow-diverters. MATERIALS ANDMETHODS:
A systematic search was performed in PubMed, MEDLINE, and EMBASE. We selected studies reporting treatments with flow-diverters in which the device was placed across the ostium of the OphtA, PcomA, or AchorA. Random-effects meta-analysis was used to pool the followingoutcomes:
rate of arterial occlusion, diminished flow, incidence of related symptoms, factors associated with arterial occlusion.RESULT:
Twenty-one studies evaluating 1152 supraclinoid ICA branches were included in the meta-analysis. The incidence of OphtA occlusion and associated symptoms was 5.9% (95 CI% = 3.1-8.6%) (incidence rate = 6% per patient-year), and 0.8% (95% CI = 0.1-1.4%) (incidence rate = 0.8% per patient-year), respectively. Although asymptomatic in all cases, PcomA showed a higher occlusion rate (20.7%, 95% CI = 8.9-32.4%) (incidence rate = 19.5% per patient-year). AchorA was occluded in 1% (95% CI = 0.3-2.4%) of cases, with approximately 1% (95% CI = 0.4-2.3%) of transient neurological symptoms (incidence rate = 0.96% per patient-year). There was a trend toward higher odds of arterial patency among arteries arising from the aneurysm (OR = 2.94, P = 0.06). Demographic factors and multiple stents were not associated with higher risk of arterial impairment. Adequate collateral circulation was reported in 94.5% of patients with arterial occlusion.CONCLUSIONS:
During aneurysm treatment, the ostium of the supraclinoid ICA branches can be covered with flow-diverter devices with low rates of neurological symptoms related to arterial occlusion.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Grau de Desobstrução Vascular
/
Doenças das Artérias Carótidas
/
Stents
/
Aneurisma Intracraniano
/
Estenose das Carótidas
/
Aneurisma Roto
Tipo de estudo:
Systematic_reviews
Limite:
Humans
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article