Al-Jehani Hosam M, Hafez Mousa Ahmed, AlHamid May A
Department of Neurosurgery and Interventional Neuroradiology, King Fahad Hospital of the University, Dammam, SAU.
Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, CAN.
Cureus. 2024 Sep 24;16(9):e70075. doi: 10.7759/cureus.70075. eCollection 2024 Sep.
Intracranial aneurysms (IAs) pose a significant health concern, necessitating effective treatment modalities. The pCONUS device has emerged as a promising option for managing complex IAs, particularly wide-necked bifurcation aneurysms. Evaluating its efficacy across multiple studies is essential for establishing therapeutic guidelines. A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies assessing the efficacy of pCONUS devices in treating cerebral aneurysms. PubMed, Google Scholar, and Scopus were searched for relevant articles published from January 1, 2000, to December 31, 2021. Inclusion criteria encompassed clinical trials examining pCONUS device benefits for ruptured or unruptured cerebral aneurysms. Data extraction and quality assessment were performed independently by two reviewers. Out of 390 initially identified articles, eight studies met the inclusion criteria. These studies collectively involved 190 participants with intracranial aneurysms. The sample sizes ranged from seven to 40 patients, predominantly in retrospective designs. Complete occlusion rates varied from 46.8% to 100%, with a mean diameter of treated aneurysms ranging from 2.5 mm to 8.83 mm. This systematic review suggests that pCONUS devices are feasible and effective for treating complex bifurcation cerebral aneurysms, with acceptable complication rates. Despite limitations such as retrospective study designs and limited follow-up durations, the findings support the beneficial role of pCONUS devices in managing challenging intracranial aneurysms. Larger collaborative efforts with longer follow-up durations are warranted to validate these findings and establish wider therapeutic guidelines.
颅内动脉瘤（IAs）对健康构成重大威胁，因此需要有效的治疗方式。pCONUS装置已成为治疗复杂颅内动脉瘤（尤其是宽颈分叉动脉瘤）的一种有前景的选择。在多项研究中评估其疗效对于制定治疗指南至关重要。按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行了一项系统评价，以确定评估pCONUS装置治疗脑动脉瘤疗效的研究。在PubMed、谷歌学术和Scopus上搜索了2000年1月1日至2021年12月31日发表的相关文章。纳入标准包括检查pCONUS装置对破裂或未破裂脑动脉瘤益处的临床试验。由两名审阅者独立进行数据提取和质量评估。在最初识别的390篇文章中，有8项研究符合纳入标准。这些研究总共涉及190名颅内动脉瘤患者。样本量从7例到40例不等，主要采用回顾性设计。完全闭塞率从46.8%到100%不等，治疗动脉瘤的平均直径从2.5毫米到8.83毫米不等。这项系统评价表明，pCONUS装置治疗复杂分叉脑动脉瘤是可行且有效的，并发症发生率可接受。尽管存在回顾性研究设计和随访时间有限等局限性，但研究结果支持pCONUS装置在处理具有挑战性的颅内动脉瘤方面的有益作用。需要更大规模的合作努力和更长的随访时间来验证这些发现并制定更广泛的治疗指南。
