• Leonardo B Oliveira, Marcelo Porto Sousa, Filipi Fim Andreão, Milena Zadra Prestes, Lucca B Palavani, Sávio Batista, Stefan W Koester, Nicollas Nunes Rabelo, Raphael Bertani, Leonardo C Welling, Eberval G Figueiredo, and Michael T Lawton.
• Department of Neurosurgery, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil. Electronic address: leobarrosoliveira09@gmail.com.
• World Neurosurg. 2024 Jul 1; 187: 223235.e4223-235.e4.

BackgroundDespite 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.MethodsFollowing 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.ResultsOf 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%).ConclusionsIC-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.Copyright © 2024 Elsevier Inc. All rights reserved.

14 keywords...

hide…