目的:WovenEndoBridge(WEB)装置治疗破裂颅内动脉瘤(IAs)的临床结果和血管造影结果数据有限。我们对WEB设备治疗破裂IAs的最新文献进行了荟萃分析。
方法:对4个数据库进行全面文献检索(PubMed,WebofScience,科克伦图书馆,和Embase)是针对2010年1月1日至2020年12月31日发表的研究进行的。两名评审员使用预先指定的数据收集表独立提取变量(动脉瘤和患者特征)。研究结果包括初始和最新随访血管造影结果,技术成功率,围手术期死亡率,退却率,围手术期再出血,并发症,术中破裂,出院时良好的神经系统结果。我们使用随机效应模型来汇集数据。
结果:我们最终提供了7篇文章的结果,包括276例283个动脉瘤患者。初始完全和充分闭塞率为38%(95%CI,25%-50%)和98%(95%CI,95%-100%),分别。最新随访完成和充分闭塞率分别为61%(95%CI,46%-75%)和91%(95%CI,84%-98%),分别。技术成功率为99%(95%CI,98%-100%)。围手术期死亡率和围手术期再出血率分别为9%(95%CI,3%-15%)和1%(95%CI,0%-2%),分别。回复率为6%(95%CI,3%-10%)。总体和WEB治疗相关的血栓栓塞并发症为10%(95%CI,6%-13%)和7%(95%CI,2%-12%),分别。术中破裂率为3%(95%CI,0%-6%)。
结论:使用WEB设备对破裂的IAs进行血管内治疗具有良好的安全性和可接受的动脉瘤闭塞率。
OBJECTIVE: The clinical outcome and angiographic outcome data of Woven EndoBridge (WEB) device for the treatment of ruptured intracranial aneurysms (IAs) are limited. We conducted a meta-analysis of the latest literature on the WEB device in the treatment of ruptured IAs.
METHODS: A comprehensive literature search of 4 databases (PubMed, Web of Science, Cochrane library, and Embase) was conducted for studies published from January 1, 2010 to December 31, 2020. Two reviewers independently extracted variables (aneurysm and patient characteristics) using a prespecified data-collection sheet. Outcomes studied included initial and latest follow-up angiographic outcomes, technical success rate, perioperative mortality, retreated rate, perioperative re-bleeding, complication, intraoperative rupture, favorable neurologic outcome at discharge. We used random-effects model to pool the data.
RESULTS: We finally presented the results of 7 articles including 276 patients with 283 aneurysms. Initial complete and adequate occlusion rate were 38% (95% CI, 25%-50%) and 98% (95% CI, 95%-100%), respectively. Latest follow-up complete and adequate occlusion rate were 61% (95% CI, 46%-75%) and 91% (95% CI, 84%-98%), respectively.Technical success rate was 99% (95% CI, 98%-100%). Perioperative mortality rates and perioperative re-bleeding rate were 9% (95% CI, 3%-15%) and 1% (95% CI, 0%-2%), respectively. Retreated rate was 6% (95% CI, 3%-10%). Overall and WEB treatment-related thromboembolic complication was 10% (95% CI, 6%-13%) and 7% (95% CI, 2%-12%), respectively. Intraoperative rupture rate was 3% (95% CI, 0%-6%).
CONCLUSIONS: Endovascular treatment of ruptured IAs with the WEB device has a good safety profile and an acceptable aneurysm occlusion rate.