Abstract：
BACKGROUND: Despite the recent increase in publications centered on intracranial-intracranial (IC-IC) bypasses for complex aneurysms, there is no systematic evidence regarding their outcomes. The purpose was to assess the outcomes of patients subjected to IC-IC bypass for aneurysms.
METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, a systematic review was conducted. Criteria for inclusion entailed studies with a cohort of at least 4 patients having undergone IC-IC bypass for aneurysms, detailing at least one outcome, such as patency, clinical outcomes, complications, and procedure-related mortality. When the study included patients who had undergone extracranial-intracranial (EC-IC) bypass, the authors extracted the patency and clinical data to juxtapose them with the results of IC-IC.
RESULTS: Of the 2509 shortlisted studies, 22 met our inclusion criteria, encompassing 255 patients and 263 IC-IC bypass procedures. The IC-IC bypass procedure exhibited a patency rate of 93% (95% confidence interval [CI]: 89%-95%). The patency rate of IC-IC and EC-IC bypasses did not significantly differ (odds ratio=0.60 [95% CI: 0.18-1.96]). Concerning clinical outcomes, 91% of the IC-IC patients had positive results (95% CI: 85%-97%), with no significant disparity between the IC-IC and EC-IC groups (odds ratio=1.29 [95% CI: 0.43-3.88]). After analysis, the complication rate was 11% (95% CI: 5%-18%). Procedure-related mortality was 1% (95% CI: 0%-4%).
CONCLUSIONS: IC-IC bypass is valuable for the treatment of complex intracranial aneurysms, boasting high patency and positive clinical outcomes. Complications are unusual, and procedure-related mortality is minimal. Comparing IC-IC and EC-IC led to no significant differences.
METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, a systematic review was conducted. Criteria for inclusion entailed studies with a cohort of at least 4 patients having undergone IC-IC bypass for aneurysms, detailing at least one outcome, such as patency, clinical outcomes, complications, and procedure-related mortality. When the study included patients who had undergone extracranial-intracranial (EC-IC) bypass, the authors extracted the patency and clinical data to juxtapose them with the results of IC-IC.
RESULTS: Of the 2509 shortlisted studies, 22 met our inclusion criteria, encompassing 255 patients and 263 IC-IC bypass procedures. The IC-IC bypass procedure exhibited a patency rate of 93% (95% confidence interval [CI]: 89%-95%). The patency rate of IC-IC and EC-IC bypasses did not significantly differ (odds ratio=0.60 [95% CI: 0.18-1.96]). Concerning clinical outcomes, 91% of the IC-IC patients had positive results (95% CI: 85%-97%), with no significant disparity between the IC-IC and EC-IC groups (odds ratio=1.29 [95% CI: 0.43-3.88]). After analysis, the complication rate was 11% (95% CI: 5%-18%). Procedure-related mortality was 1% (95% CI: 0%-4%).
CONCLUSIONS: IC-IC bypass is valuable for the treatment of complex intracranial aneurysms, boasting high patency and positive clinical outcomes. Complications are unusual, and procedure-related mortality is minimal. Comparing IC-IC and EC-IC led to no significant differences.
摘要：
背景：尽管最近以颅内-颅内（IC-IC）旁路术为中心的出版物有所增加，没有关于其结果的系统证据。目的是评估接受IC-IC旁路术治疗动脉瘤的患者的预后。
方法：遵循PRISMA，进行了系统审查。纳入标准需要对至少四名因动脉瘤而接受IC-IC搭桥术的患者进行研究。详述至少一个结果，如通畅，临床结果，并发症,与手术相关的死亡率。当研究包括接受过颅内外（EC-IC）搭桥术的患者时，作者提取了通畅性和临床数据，将其与IC-IC的结果并列。
结果：在2,509项入围研究中，22符合我们的纳入标准，包括255名患者和263例IC-IC旁路手术。IC-IC旁路手术显示93％的通畅率（95％CI：89％-95％）。IC-IC和EC-IC旁路的通畅率没有显着差异（OR=0.60（95％CI：0.18-1.96）。关于临床结果，91％的IC-IC患者有阳性结果（95％CI：85％-97％），IC-IC组和EC-IC组之间没有显着差异（OR=1.29（95％CI：0.43-3.88）。经过分析,并发症发生率为11％（95％CI：5％-18％）。手术相关死亡率为1%(95%CI:0%-4%)。
结论：IC-IC旁路术对于复杂颅内动脉瘤的治疗是有价值的，拥有高通畅性和积极的临床结果。并发症是不寻常的，与手术相关的死亡率最低。比较IC-IC和EC-IC没有显着差异。
方法：遵循PRISMA，进行了系统审查。纳入标准需要对至少四名因动脉瘤而接受IC-IC搭桥术的患者进行研究。详述至少一个结果，如通畅，临床结果，并发症,与手术相关的死亡率。当研究包括接受过颅内外（EC-IC）搭桥术的患者时，作者提取了通畅性和临床数据，将其与IC-IC的结果并列。
结果：在2,509项入围研究中，22符合我们的纳入标准，包括255名患者和263例IC-IC旁路手术。IC-IC旁路手术显示93％的通畅率（95％CI：89％-95％）。IC-IC和EC-IC旁路的通畅率没有显着差异（OR=0.60（95％CI：0.18-1.96）。关于临床结果，91％的IC-IC患者有阳性结果（95％CI：85％-97％），IC-IC组和EC-IC组之间没有显着差异（OR=1.29（95％CI：0.43-3.88）。经过分析,并发症发生率为11％（95％CI：5％-18％）。手术相关死亡率为1%(95%CI:0%-4%)。
结论：IC-IC旁路术对于复杂颅内动脉瘤的治疗是有价值的，拥有高通畅性和积极的临床结果。并发症是不寻常的，与手术相关的死亡率最低。比较IC-IC和EC-IC没有显着差异。
