血流导向装置治疗颅内动脉瘤的疗效评价：一项包含前后循环大样本研究的荟萃分析。
Whether Intracranial Aneurysm Could Be Well Treated by Flow Diversion: A Comprehensive Meta-Analysis of Large-Sample Studies including Anterior and Posterior Circulation.
机构信息
Department of Neurosurgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China.
出版信息
Biomed Res Int. 2021 Mar 8;2021:6637780. doi: 10.1155/2021/6637780. eCollection 2021.
BACKGROUND
Flow diversion (FD) has become a widely adopted treatment method for intracranial aneurysms in the clinic, but a comprehensive meta-analysis of large-sample studies including anterior and posterior circulation is still lacking.
METHODS
The PubMed, Embase, Web of Science, and Cochrane databases were searched between January 1, 2008, and December 1, 2019. A random-effect model was used to calculate the efficacy and safety data as well as 95% confidence intervals (CIs).
RESULTS
The pooled sample size of all included studies was 6695 patients; the mean age was 55.5 years old, with a total of 7406 aneurysms. For efficacy, the complete occlusion rate in angiographic follow-up (AFU) at 6 months was 78% (95% CI, 0.77, 0.80), and the AFU rate at 6-12 months was 90% (95% CI, 0.88, 0.92). For safety, the hemorrhagic event rate was 2%, the ischemic event rate was 5%, and the mortality rate was 3%.
CONCLUSION
FD is an effective and safe treatment for intracranial aneurysm with high complete occlusion rate and acceptable complication rate.
背景
血流导向装置（FD）已在临床上广泛应用于颅内动脉瘤的治疗，但仍缺乏包括前循环和后循环的大样本综合荟萃分析。
方法
检索了 2008 年 1 月 1 日至 2019 年 12 月 1 日期间的 PubMed、Embase、Web of Science 和 Cochrane 数据库。使用随机效应模型计算疗效和安全性数据及 95%置信区间（CI）。
结果
所有纳入研究的汇总样本量为 6695 例患者；平均年龄为 55.5 岁，共 7406 个动脉瘤。在疗效方面，血管造影随访（AFU）中 6 个月时的完全闭塞率为 78%（95%CI，0.77，0.80），6-12 个月时的 AFU 率为 90%（95%CI，0.88，0.92）。在安全性方面，出血事件发生率为 2%，缺血性事件发生率为 5%，死亡率为 3%。
结论
FD 是一种治疗颅内动脉瘤的有效且安全的方法，具有较高的完全闭塞率和可接受的并发症发生率。
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