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用于治疗颅内动脉瘤的超越进化血流导向装置:一项系统评价。

Surpass Evolve Flow Diverter for the Treatment of Intracranial Aneurysm: A Systematic Review.

作者信息

Issa Rania, Al-Homedi Zahrah, Syed Dawood Hasan, Aziz Waseem, Al-Omari Basem

机构信息

College of Medicine and Health Sciences, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates.

Department of Neurosurgery, Sheikh Shakhbout Medical City, Abu Dhabi P.O. Box 11001, United Arab Emirates.

出版信息

Brain Sci. 2022 Jun 20;12(6):810. doi: 10.3390/brainsci12060810.

Abstract

PURPOSE

This systematic review aims to summarize the evidence investigating the effectiveness and safety of the Surpass Evolve-Flow Diverter (SE-FD) to treat brain aneurysms.

METHOD

We searched MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane Library from January 2019 to 29 March 2022. Terms related to the "intracranial aneurysm" and "surpass evolve flow diverter" concepts were used to search the databases; Medical Subject Headings (MeSH) and reference hand search were also utilized.

RESULTS

The searches primarily identified 1586 documents. A total of five studies (four case series and one cohort) were included in this review. In the included studies, 192 (74 male and 118 females) patients with 198 aneurysms were involved. In total, 153 SE-FDs were used to treat 145 aneurysms. Complete occlusion was achieved in 69/145 (48%) cases and near-complete occlusion in 24/145 (17%) cases from aneurysms treated with SE-FD. Reported postoperative complications included stent thrombosis ( = 4 patients), hemorrhage ( = 5 patients), ischemia ( = 9 patients), and neurological complications ( = 12 patients). In total, four deaths were reported with only one related to the SE-FD procedure.

CONCLUSION

The results of this review are based on observational data, due to the absence of clinical trials. The findings of the included studies suggest that the effectiveness of the SE-FD procedure is lower than previous FDs but the safety is similar. The included studies also suggested that SE-FD has navigability and resistance to twisting, which makes the procedure an easier method to treat aneurysms that are proximal and distal to the circle of Willis deployment. This review highlights the urgency to conduct clinical trials to confirm these suggestions.

摘要

目的

本系统评价旨在总结有关Surpass Evolve-Flow分流器(SE-FD)治疗脑动脉瘤有效性和安全性的研究证据。

方法

我们检索了2019年1月至2022年3月29日期间的MEDLINE、EMBASE、CINAHL、Web of Science和Cochrane图书馆。使用与“颅内动脉瘤”和“Surpass Evolve血流分流器”概念相关的术语检索数据库;还利用了医学主题词(MeSH)和参考文献手工检索。

结果

检索主要识别出1586篇文献。本评价共纳入五项研究(四项病例系列研究和一项队列研究)。在纳入的研究中,涉及192例患者(74例男性和118例女性)的198个动脉瘤。总共使用153个SE-FD治疗145个动脉瘤。在接受SE-FD治疗的动脉瘤中,69/145(48%)例实现了完全闭塞,24/145(17%)例实现了近完全闭塞。报告的术后并发症包括支架血栓形成(4例患者)、出血(5例患者)、缺血(9例患者)和神经并发症(12例患者)。总共报告了4例死亡,其中仅1例与SE-FD手术相关。

结论

由于缺乏临床试验,本评价结果基于观察性数据。纳入研究的结果表明,SE-FD手术的有效性低于先前的血流分流器,但安全性相似。纳入研究还表明,SE-FD具有可操作性和抗扭曲性,这使得该手术成为治疗 Willis 环近端和远端动脉瘤的更简便方法。本评价强调了开展临床试验以证实这些建议的紧迫性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8921/9221455/6c969ebb204e/brainsci-12-00810-g001.jpg

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