背景:这项研究的目的是评估与分流器(FD)治疗颅内动脉瘤(IA)相关的编织变化的总体比率。此外,我们试图提供目前报道的与这些并发症相关的定义的概述.
方法:从相关文献开始到2023年4月进行了系统搜索,包括六个数据库。纳入的研究集中在用FDs治疗的IAs患者。我们考虑了FD编织变化的四个主要结果指标:(1)鱼嘴,(2)装置编织变窄,(3)装置编织塌陷,和(4)装置编织变形。这些研究的数据使用随机效应模型进行汇总。
结果:共有48项研究纳入了3572例患者的分析。其中,14项研究(39%)提供了鱼嘴的定义。然而,纳入的研究都没有提供设备编织缩窄的具体定义,崩溃,或变形,尽管这些并发症的报告率为六个,五,和三项研究,分别。编织变化的汇总率如下:3%(95%CI2%至4%,I2=27%)用于鱼嘴,7%(95%CI2%至20%,I2=85%)用于缩小,1%(95%CI0%至3%,I2=0%)用于塌陷,和1%(95%CI1%至4%,I2=0%)为变形。
结论:这项研究的结果表明,对IAs的FD治疗通常表现出较低的鱼嘴率,设备编织变窄,崩溃,和变形。然而,缺乏标准化定义阻碍了客观比较设备结果的能力,强调在未来FD的前瞻性研究中需要对FD编织变化进行统一定义。
BACKGROUND: The aim of this study was to evaluate the overall rates of braid changes associated with flow diverter (FD) treatment for intracranial aneurysms (IAs). Additionally, we sought to provide an overview of the currently reported definitions related to these complications.
METHODS: A systematic search was conducted from the inception of relevant literature up to April 2023, encompassing six databases. The included studies focused on patients with IAs treated with FDs. We considered four main outcome measures as FD braid changes: (1) fish-mouthing, (2)
device braid narrowing, (3)
device braid collapsing, and (4)
device braid deformation. The data from these studies were pooled using a random-effects model.
RESULTS: A total of 48 studies involving 3572 patients were included in the analysis. Among them, 14 studies (39%) provided definitions for fish-mouthing. However, none of the included studies offered specific definitions for
device braid narrowing, collapsing, or deformation, despite reporting rates for these complications in six, five, and three studies, respectively. The pooled rates for braid changes were as follows: 3% (95% CI 2% to 4%, I2=27%) for fish-mouthing, 7% (95% CI 2% to 20%, I2=85%) for narrowing, 1% (95% CI 0% to 3%, I2=0%) for collapsing, and 1% (95% CI 1% to 4%, I2=0%) for deformation.
CONCLUSIONS: The findings of this study suggest that FD treatment for IAs generally exhibits low rates of fish-mouthing,
device braid narrowing, collapsing, and deformation. However, the lack of standardized definitions hinders the ability to compare
device outcomes objectively, emphasizing the need for uniform definitions for FD braid changes in future prospective studies on FD.