Fahed Robert, Raymond Jean, Ducroux Célina, Gentric Jean-Christophe, Salazkin Igor, Ziegler Daniela, Gevry Guylaine, Darsaut Tim E
Centre Hospitalier de l'Université de Montréal (CHUM), Research Centre, Interventional Neuroradiology Laboratory, Montreal, Quebec, Canada.
Centre Hospitalier de l'Université de Montréal (CHUM), Notre-Dame Hospital, Department of Radiology, 1560 Sherbrooke East, Pavilion Simard, Suite Z12909, Montreal, Quebec, Canada, H2L 4M1.
Neuroradiology. 2016 Apr;58(4):375-82. doi: 10.1007/s00234-015-1635-0. Epub 2016 Jan 8.
Flow diversion (FD) is increasingly used to treat intracranial aneurysms. We sought to systematically review published studies to assess the quality of reporting and summarize the results of FD in various animal models.
Databases were searched to retrieve all animal studies on FD from 2000 to 2015. Extracted data included species and aneurysm models, aneurysm and neck dimensions, type of flow diverter, occlusion rates, and complications. Articles were evaluated using a checklist derived from the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines.
Forty-two articles reporting the results of FD in nine different aneurysm models were included. The rabbit elastase-induced aneurysm model was the most commonly used, with 3-month occlusion rates of 73.5%, (95%CI [61.9-82.6%]). FD of surgical sidewall aneurysms, constructed in rabbits or canines, resulted in high occlusion rates (100% [65.5-100%]). FD resulted in modest occlusion rates (15.4% [8.9-25.1%]) when tested in six complex canine aneurysm models designed to reproduce more difficult clinical contexts (large necks, bifurcation, or fusiform aneurysms). Adverse events, including branch occlusion, were rarely reported. There were no hemorrhagic complications. Articles complied with 20.8 ± 3.9 of 41 ARRIVE items; only a small number used randomization (3/42 articles [7.1%]) or a control group (13/42 articles [30.9%]).
Preclinical studies on FD have shown various results. Occlusion of elastase-induced aneurysms was common after FD. The model is not challenging but standardized in many laboratories. Failures of FD can be reproduced in less standardized but more challenging surgical canine constructions. The quality of reporting could be improved.
血流导向（FD）越来越多地用于治疗颅内动脉瘤。我们试图系统回顾已发表的研究，以评估报告质量并总结FD在各种动物模型中的结果。
检索数据库以获取2000年至2015年所有关于FD的动物研究。提取的数据包括物种和动脉瘤模型、动脉瘤和瘤颈尺寸、血流导向器类型、闭塞率和并发症。使用源自《动物研究：体内实验报告》（ARRIVE）指南的清单对文章进行评估。
纳入了42篇报告FD在9种不同动脉瘤模型中结果的文章。兔弹性蛋白酶诱导的动脉瘤模型是最常用的，3个月闭塞率为73.5%，（95%置信区间[61.9 - 82.6%]）。在兔或犬构建的手术侧壁动脉瘤进行FD，导致高闭塞率（100%[65.5 - 100%]）。在六种旨在再现更具挑战性临床情况（大瘤颈、分叉或梭形动脉瘤）的复杂犬动脉瘤模型中进行FD测试时，闭塞率适中（15.4%[8.9 - 25.1%]）。很少报告包括分支闭塞在内的不良事件。没有出血并发症。文章符合41项ARRIVE条目中的20.8±3.9项；只有少数文章使用了随机化（3/42篇文章[7.1%]）或对照组（13/42篇文章[30.9%]）。
FD的临床前研究显示了不同的结果。FD后弹性蛋白酶诱导的动脉瘤闭塞很常见。该模型在许多实验室中虽不具挑战性但却是标准化的。在标准化程度较低但更具挑战性的手术犬模型构建中可再现FD失败情况。报告质量有待提高。
