Florez William A, Garcia-Ballestas Ezequiel, Quiñones-Ossa Gabriel Alexander, Janjua Tariq, Konar Subhas, Agrawal Amit, Moscote-Salazar Luis Rafael
Latin American Council of Neurocritical Care (CLaNi), Cartagena, Colombia.
Center of Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia.
Neurointervention. 2021 Nov;16(3):222-231. doi: 10.5469/neuroint.2021.00234. Epub 2021 Sep 14.
Flow diverters have become a critical instrument for complex aneurysms treatment. However, limited data are currently available regarding short and long-term outcomes for the Silk flow diverter. The objective of the study is to determine neurological prognosis and mortality rates for the Silk flow diversion device used in intracranial aneurysms. A systematic review with meta-analysis was performed using databases. The following descriptors were used for the search: "SILK", "Flow Diverter", "Mortality", and "Prognosis". The following data were extracted: mortality, good functional outcome, Glasgow outcome scale, complete or near-complete occlusion rates, rate of retreatment, and complications (thromboembolic and hemorrhagic complications). A total of 14 studies were selected. Among the 14 studies, 13 were retrospective observational cohort studies and 1 was a prospective observational cohort study. The mortality rate was 2.84%. The clinical good outcomes rate was 93.3%. The poor outcome rate was 6.6%. The overall thromboembolic complication rate was 6.06% (95% confidence interval [CI] 0.00-6.37, P=0.12, I2=3.13%). The total hemorrhagic complication rate was 1.62% (95% CI 0.00-5.34, P=0.28, I2=1.56%). The complete aneurysm occlusion rate was 80.4% (95% CI 8.65-9.38, P<0.0001, I2=9.09%). The Silk diverter device has a good safety and efficacy profile for treating intracranial aneurysms with high complete occlusion rates.
血流导向装置已成为治疗复杂动脉瘤的关键器械。然而,目前关于Silk血流导向装置的短期和长期疗效的数据有限。本研究的目的是确定用于颅内动脉瘤的Silk血流导向装置的神经学预后和死亡率。使用数据库进行了一项系统评价和荟萃分析。搜索使用了以下描述词:“SILK”、“血流导向装置”、“死亡率”和“预后”。提取了以下数据:死亡率、良好功能结局、格拉斯哥结局量表、完全或近乎完全闭塞率、再治疗率以及并发症(血栓栓塞性和出血性并发症)。共纳入14项研究。在这14项研究中,13项为回顾性观察队列研究,1项为前瞻性观察队列研究。死亡率为2.84%。临床良好结局率为93.3%。不良结局率为6.6%。总体血栓栓塞性并发症发生率为6.06%(95%置信区间[CI]0.00 - 6.37,P = 0.12,I2 = 3.13%)。总出血性并发症发生率为1.62%(95% CI 0.00 - 5.34,P = 0.28,I2 = 1.56%)。动脉瘤完全闭塞率为80.4%(95% CI 8.65 - 9.38,P < 0.0001,I2 = 9.09%)。Silk血流导向装置在治疗颅内动脉瘤方面具有良好的安全性和有效性,完全闭塞率高。