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血流导向腔内装置(FRED)治疗颅内动脉瘤的安全性和有效性:一项系统评价和荟萃分析。

Safety and efficacy of flow redirection endoluminal device (FRED) for treatment of intracranial aneurysm; A systematic review and meta-analysis.

作者信息

Habibi Mohammad Amin, Mirjani Mohammad Sina, Ahmadzadeh Amir Mahmoud, Akbari Javar Mohammad Taha, Karami Shaghayegh, Ahmadvand Muhammad Hussain

机构信息

Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Student Research Committee, Qom University of Medical Sciences, Qom, Iran.

出版信息

Neuroradiol J. 2025 Apr;38(2):142-175. doi: 10.1177/19714009241269460. Epub 2024 Aug 5.

Abstract

BackgroundPrevious research has shown promising results for treating intracranial aneurysms (IAs) with a flow redirection endoluminal device (FRED). In this systematic review and meta-analysis, we aimed to assess the safety and efficacy of this device by providing pooled estimates using the data from previous studies.MethodsA systematic literature search of Web of Sciences, PubMed, Scopus, and Embase was performed until October 8th, 2023. After selecting the final articles, relevant data were extracted. Parameters relating to safety and efficacy were pooled using STATA software. Heterogeneity was assessed using I-squared and Cochran's Q. Funnel plots and Egger's regression methods were used to evaluate publication bias. Sensitivity analysis was also performed using the leave-one-out method.ResultsThe data of 37 studies were used for meta-analysis. The rates of immediate adequate occlusion and complete occlusion were 0.51 (95% CI: 0.31-0.71) and 0.34 (95% CI: 0.16-0.53), respectively, while the rates of the adequate and complete occlusion at the latest follow-up were 0.90 (95% CI: 0.84-0.94) and 0.75 (95% CI: 0.65-0.84), respectively. The periprocedural complications rate was 0.04 (95% CI: 0.03-0.06), and the overall complications rate was 0.12 (95% CI: 0.09-0.15). The rate of good functional outcome was 0.99 (95% CI: 0.99-1.00) and the successful implantation rate was 1.00 (95% CI: 1.00-1.00). There was substantial heterogeneity among the reports for most of the evaluated parameters.ConclusionFRED had high safety and efficacy in treating IAs, as evidenced by its high occlusion and low complication rates.

摘要

背景

先前的研究表明,使用血流导向腔内装置(FRED)治疗颅内动脉瘤(IA)取得了有前景的结果。在这项系统评价和荟萃分析中,我们旨在通过汇总先前研究的数据来评估该装置的安全性和有效性。

方法

对Web of Sciences、PubMed、Scopus和Embase进行了系统的文献检索,直至2023年10月8日。在选定最终文章后,提取了相关数据。使用STATA软件汇总与安全性和有效性相关的参数。使用I²和Cochran's Q评估异质性。采用漏斗图和Egger回归方法评估发表偏倚。还使用留一法进行了敏感性分析。

结果

37项研究的数据用于荟萃分析。即刻充分栓塞率和完全栓塞率分别为0.51(95%CI:0.31 - 0.71)和0.34(95%CI:0.16 - 0.53),而最新随访时的充分栓塞率和完全栓塞率分别为0.90(95%CI:0.84 - 0.94)和0.75(95%CI:0.65 - 0.84)。围手术期并发症发生率为0.04(95%CI:0.03 - 0.06),总体并发症发生率为0.12(95%CI:0.09 - 0.15)。良好功能结局率为0.99(95%CI:0.99 - 1.00),成功植入率为1.00(95%CI:1.00 -

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