• Federico Cagnazzo, Pierre-Henri Lefevre, Daniel Mantilla, Aymeric Rouchaud, Riccardo Morganti, Paolo Perrini, Davide Di Carlo, Cyril Dargazanli, Gregory Gascou, Carlos Riquelme, Alain Bonafe, and Vincent Costalat.
• Neuroradiology department, university hospital Gui-de-Chauliac, CHU de Montpellier, 34000 Montpellier, France. Electronic address: f.cagnazzo86@gmail.com.
• J Neuroradiology. 2019 Feb 1; 46 (1): 9-14.

Background And PurposePlacement 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 And MethodsA 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 following outcomes: rate of arterial occlusion, diminished flow, incidence of related symptoms, factors associated with arterial occlusion.ResultTwenty-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.ConclusionsDuring 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.Copyright © 2018 Elsevier Masson SAS. All rights reserved.

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