■颈内动脉假性动脉瘤(PSA)是一种罕见但严重的脑血管疾病,难以手术修复。一种名为Willis覆膜支架(WCS)的新型医疗设备已被创造出来,尤其是用于治疗复杂的脑血管疾病。然而,WCS治疗PSA的有效性和安全性仍有争议.需要额外的实质性证据。
■为了找到与PSA的WCS治疗有关的研究,在Medline进行了系统的文献回顾,Embase,WebofScience,CNKI,万方,和CBM数据库。结果包括术中情况的数据,术后情况,随后将随访纳入荟萃分析.
■11项非比较性研究符合该标准,共152例患者和157例PSA。技术成功率接近100%(>0.999(95%置信区间(CI),0.958,1.000)),完全闭塞率为97.8%(95%CI,0.932,1.000),侧支闭塞率为0.5%(95%CI,0.001,0.045)。急性支架内血栓形成(<0.001(95%CI,0.000,0.013))和出血(<0.001(95%CI,0.000,0.005))的发生率均小于0.1%。在术后情况下,手术相关死亡率低于0.1%(<0.001(95%CI,0.000,0.005)).复发率(<0.001(95%CI,0.000,0.002))和父动脉狭窄(<0.001(95%CI,0.000,0.008))均小于0.1%,而晚期支架内狭窄发生在1.3%(95%CI,0.000,0.053)的患者中.最后,98.5%(95%CI,0.943,1.000)的患者预后良好。
■WCS的应用对PSA可能是有效和安全的。这项研究的结果可以作为即将进行的临床试验的参考。
UNASSIGNED: Pseudoaneurysm (PSA) of internal carotid artery is a rare but severe cerebrovascular disease and difficult to repair surgically. A novel medical device called Willis covered stent (WCS) has been created especially for the treatment of complex cerebrovascular diseases. However, the efficacy and safety of WCS therapy for PSA are still debatable. Additional substantial proof is needed.
UNASSIGNED: To find research pertaining to WCS treatment for PSA, a systematic review of literature was conducted in the Medline, Embase, Web of Science, CNKI, Wanfang, and CBM databases. The results comprising the data of intraoperative situation, postoperative situation, and follow-up were then included in a meta-analysis.
UNASSIGNED: The criteria were met by 11 noncomparative studies with 152 patients and 157 PSAs. Technical success rate was nearly 100 % (>0.999 (95 % confidence interval (CI), 0.958, 1.000)), complete occlusion rate was 97.8 % (95 % CI, 0.932, 1.000), and side branch occlusion rate was 0.5 % (95 % CI, 0.001, 0.045). The rates of acute in-stent thrombosis (<0.001 (95 % CI, 0.000, 0.013)) and hemorrhage (<0.001 (95 % CI, 0.000, 0.005)) were both less than 0.1 %. In postoperative situation, surgery-related mortality rate was less than 0.1 % (<0.001 (95 % CI, 0.000, 0.005)). The rates of recurrence (<0.001 (95 % CI, 0.000, 0.002)) and parent artery stenosis (<0.001 (95 % CI, 0.000, 0.008)) were both less than 0.1 %, while late in-stent stenosis occurred in 1.3 % (95 % CI, 0.000, 0.053) of patients. In the end, 98.5 % (95 % CI, 0.943, 1.000) of patients had a good outcome.
UNASSIGNED: The application of WCS could be effective and safe for PSAs. The findings of this study could serve as a reference for upcoming clinical trials.