Batista Sávio, Palavani Lucca B, Verly Gabriel, Ferreira Marcio Yuri, Sanches João Pedro Bittar, Silva Guilherme Melo, Pinheiro Agostinho C, Almeida Filho José Alberto
Faculty of Medicine, Federal University of Rio de Janeiro, Brazil.
Faculty of Medicine, Max Planck University Center, Brazil.
Neuroradiol J. 2025 Feb;38(1):21-29. doi: 10.1177/19714009241269457. Epub 2024 Jul 31.
Open cell stents (OC) and closed cell stents (CC) each offer unique advantages and potential drawbacks in the context of idiopathic intracranial hypertension (IIH) treatment. We aim to investigate the safety and efficacy of using OC and CC for IIH. We conducted a systematic review in PubMed, Embase, and Cochrane Library databases following the PRISMA guidelines. Eligible studies included ≥4 patients with IIH treated by OC or CC. Primary outcomes were headache, visual acuity, and papilledema status before and after the procedure. Additionally, failure rate, minor complications, major complications, and total complications were assessed. Pooled analysis of the OC group and CC group were done separately and then compared. Twenty-four studies were included. Of these, 20 reported on OC and 6 reported on CC. Pooled analysis of failure rate was 8% (4%-12%) in OC and 5% (0%-11%) in CC. For headache improvement rate: 78% (70%-86%) in OC and 81% (66%-69%) in CC. For visual acuity improvement: 78% (65%-92%) in OC and 76% (29%-100%) in CC. For papilledema improvement: 88% (77%-98%) in OC and 82% (67%-98%) in CC. For minor complications: 0% (0%-1%) in OC and 0% (0%-2%) in CC. For major complications: 0% (0%-1%) in OC and 2% (0%-6%) in CC. Total complications: 0% (0%-1%) in OC and 2% (0%-6%) in CC. Low failure and complication rates were found in both OC and CC, with no significant difference between them in effectiveness. The CC showed a slight but significant increase in major and total complications compared to the OC. Additionally, a subtle yet significantly lower failure rate was identified in the CC.
开孔支架（OC）和闭孔支架（CC）在特发性颅内高压（IIH）治疗中各自具有独特的优势和潜在的缺点。我们旨在研究使用OC和CC治疗IIH的安全性和有效性。我们按照PRISMA指南在PubMed、Embase和Cochrane图书馆数据库中进行了系统评价。符合条件的研究包括≥4例接受OC或CC治疗的IIH患者。主要结局是手术前后的头痛、视力和视乳头水肿状态。此外，评估了失败率、轻微并发症、严重并发症和总并发症。分别对OC组和CC组进行汇总分析，然后进行比较。共纳入24项研究。其中，20项报告了OC，6项报告了CC。OC组失败率的汇总分析为8%（4%-12%），CC组为5%（0%-11%）。头痛改善率：OC组为78%（70%-86%），CC组为81%（66%-69%）。视力改善率：OC组为78%（65%-92%），CC组为76%（29%-100%）。视乳头水肿改善率：OC组为88%（77%-98%），CC组为82%（67%-98%）。轻微并发症：OC组为0%（0%-1%），CC组为0%（0%-2%）。严重并发症：OC组为0%（0%-1%），CC组为2%（0%-6%）。总并发症：OC组为0%（0%-1%），CC组为2%（0%-6%）。OC和CC的失败率和并发症发生率均较低，两者在有效性方面无显著差异。与OC相比，CC的严重并发症和总并发症略有但显著增加。此外，CC的失败率略有但显著降低。
