• World Neurosurg · Jun 2019

    Meta Analysis

    Dual stent-assisted coil embolization for intracranial wide-necked bifurcation aneurysms: a single-center experience and a systematic review and meta-analysis.

    • Gaici Xue, Qiao Zuo, Guoli Duan, Xiaoxi Zhang, Rui Zhao, Qiang Li, Yibin Fang, Pengfei Yang, Dongwei Dai, Kaijun Zhao, Bo Hong, Yi Xu, Jianmin Liu, and Qinghai Huang.
    • Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
    • World Neurosurg. 2019 Jun 1; 126: e295-e313.

    ObjectiveTo evaluate the safety and efficacy of dual stent-assisted coiling in treatment of intracranial complex and wide-necked bifurcation aneurysms, we have reported our own center experience and performed a systematic review and meta-analysis of the reported data.MethodsThe experience in our center was reviewed and a comprehensive search of the reported data on dual stent-assisted treatment of intracranial complex and wide-necked bifurcation aneurysms was performed using the databases PubMed, Ovid EMBASE, and Ovid MEDLINE before October 1, 2018. Information was extracted regarding patient demographic data, clinical characteristics, radiographic data, treatment outcomes, complications, and clinical and angiographic follow-up data. The data were analyzed using random effects and fixed effects meta-analyses.ResultsIncluding our series of 26 patients, the data from 21 studies with 721 patients were analyzed. The procedure was technically successful in 97.6% (95% confidence interval [CI], 96.5%-98.7%). The complete occlusion rate was 61.6% (95% CI, 47.3%-75.8%) immediately after the procedure compared with 88.4% (95% CI, 84.6%-92.2%) at the last follow-up examination. The rate of periprocedural complications, total complications, procedure-related mortality was 8.8% (95% CI, 5.8%-11.9%), 9.5% (95% CI, 6.2%-12.9%), and 1.1% (95% CI, 0.3%-1.8%), respectively. The recurrence rate, retreatment rate, and good neurologic outcome rate was 3.3% (95% CI, 2.0%-4.7%), 2.7% (95% CI, 1.5%-4.0%), and 96.6% (95% CI, 95.0%-98.1%), respectively.ConclusionsThe dual stent-assisted coiling technique is a feasible and effective option for the treatment of intracranial complex and wide-necked bifurcation aneurysms. It results in a relatively low rate of procedure-related complications and mortality and recurrence and a high rate of mid-term complete occlusion and good neurologic outcomes.Copyright © 2019 Elsevier Inc. All rights reserved.

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