Introduction
Methods
Search Strategy
Data Collection and Analysis
Results
Description of Studies
Characteristics of Aneurysms
Reference | Number of patients (IA) | Morphology | Location | Mean sized (mm) | Size groupe
| Clinical presentations by IAs | Acute SAH | Previous treatment | Number of PED used (mean number per IA) | Adjuvant coiling |
---|---|---|---|---|---|---|---|---|---|---|
McAuliffe et al. [15] | 54 (57) | 46 saccular; 11 fusiform | 46 Ant; 11 Post | 13.1 | 18 small; 32 large; 7 giant | 41 asymptomatic; 16 mass effect | 0 | 15 EVT; 1 clipping | 98 (1.7) | 6 |
McAuliffe and Wenderoth [14] | 11 (11) | 3 saccular; 5 blister; 3 fusiform | 5 Ant; 6 Post | 11.3 | 4 small; 6 large; 1 giant | 6 within 2 weeks; 5 within 2–4 weeks post-SAH | 11 | 1 coiling; 2 stent + coil | 17 (1.5) | 5 |
Nelson et al. [16] “PITA” | 31 (31) | 31 saccular | 29 Ant; 2 Post | 11.5 | 20 small; 9 large; 2 giant | NA | 0 | 8 coiling; 2 stenting; 2 coil + stent | 47 (1.5) | 16 |
Lubicz et al. [13] | 20 (27) | 16 saccular; 11 fusiform | 24 Ant; 3 Post | 5.0 | 24 small; 3 large | 1 acute SAH; 1 hemiparesis;18 asymptomatic | 1 | 9 IAs (details not known) | 27 (1) | 0 |
De Barros Faria et al. [18] | 23 (23) | 23 dissecting | 2 Ant; 21 Post | NA | 7 small; 7 large; 9 giant | 5 asymptomatic; 5 mass effects; 1 ischemia; 12 past SAHs | 4 | 3 stenting | 51 (2.2) | 9 |
Fischer et al. [19] | 88 (101) | 63 saccular; 33 fusiform; 5 dissecting | 79 Ant; 22 Post | 3.8 (saccular IA only) | Saccular—60 small; 3 large; Undetermined in 38 dissecting | 61 asymptomatic; 18 past SAHs; 9 cranial nerve palsies; 13 symptomatic dissection | 0 | 30 stenting; 9 coiling; 9 clipping | 66 % IAs had > 1 PED | 3 |
Food and Drug Administrationa [12] | 108 (108) | 108 saccular | 108 Ant | 18.2 | 1 small; 85 large; 22 giant | NA | 0 | 8 coiling; 1 clipping; 1 other | 341 (3.2) | 1 |
Szikora et al.b [17] | 18 (19) | 16 saccular; 3 fusiform | 18 Ant; 1 Post | 16.0 | 5 small; 10 large; 4 giant | 10 headaches; 6 mass effect; 1 failed past EVT; 2 asymptomatic | 0 | 1 EVT (details not known) | 39 (2.1) | 10 |
Lylyk et al.c [9] | 53 (63) | 55 saccular; 8 fusiform | 55 Ant; 8 Post | 11.1 | 33 small; 22 large; 8 giant | 25 asymptomatic; 6 headaches; 7 previous SAHs; 4 mass effects; 5 visual deficits; 6 cranial nerve palsies | 0 | 14 coiling; 6 stent + coil; 1 stenting; 2 clipping | 74 (1.2) | 4 |
Food and Drug administration [20] | 8 (8) | 8 saccular | 8 Ant | 7.2 | NA | NA | 0 | 0 | 16 (2) | 0 |
Total | 414 (448) | 351 saccular/blister-like; 69 fusiform; 28 dissecting | 374 Ant; 74 Post | 12.0 | 171 small; 177 large; 53 giant; 46 undetermined | – | 16 | 125 | – | 54 |
Antiplatelet and Anticoagulating Therapies
PED Placement (Tables 1 and 2)
Reference | Number of IAs | Technical problems | Symptomatic procedure-related complications | Mortality | Number of complete IA occlusion/number assessed | In-construct stenosis/migration | Recanalization after initial occlusion | Functional/symptomatic outcomes |
---|---|---|---|---|---|---|---|---|
McAuliffe et al. [15] | 57 | 1 poor deployment | 4 TIAs; 3 transient worsening of mass effect; 1 retroperitoneal hematoma | 0 | 48/56 at 6 mos | 2 stenosis 2 migration | 0 | NA |
McAuliffe and Wenderoth [14] | 11 | 1 poor deployment | 2 IA ruptures; 1 cerebellar ICH | 2 | 8/9 at 6 mos | 1 stenosis 1 migration | Not mentioned | NA |
Nelson et al. [16] | 31 | 1 failed deployment | 1 ICA rupture; 1 ischemic infarction | 0 | 28/30 at 6 mos | 1 stenosis | Not mentioned | NA |
Lubicz et al. [13] | 27 | 9 “minor technical issues” | 1 ICH; 1 SAH (not IA related); 1 retroperitoneal hematoma | 0 | 21/25 at 4–6 mos | 3 stenosis | Not mentioned | All survivors had mRS = 0 |
De Barros Faria et al. [18] | 23 | 5 “technical issues” | 1 ischemic stroke; 1 retroperitoneal hematoma | 0 | 16/23 at 6 mos | 2 stenosis | 0 | 74 % GOS 4 or 5 |
Fischer et al. [19] | 101 | 1 failed deployment | 1 IA rupture; 2 ischemic infarctions; 3 ICHs | 2 | 47/90 at 3; 36/49 at 10 mos | 0 | 0 | NA |
Food and Drug Administrationa [12] | 107 | 1 device failure | 2 ICHs; 3 ischemia infarctions; 1 unknown fatal event | 3 | 78/106 at 6 mos | 1 stenosis | 2 at 12 mos | 6 of 100 assessed worsened; others unchanged or improved |
Szikora et al. [17] | 19 | 2 failed deployment | 2 ischemic infarctions; 1 embolic occlusion of retinal artery; 1 SAH | 1 | 17/18 at 6 mos | 1 stenosis | Not mentioned | 7 unchanged; 6 of 6 mass effects improved, 5 of 10 headaches improved |
Lylyk et al. [9] | 63 | 2 failed deployment | 3 worsening of pre-existing cranial nerve palsies due to mass effect; 5 femoral hematomas; 1 contrast allergy | 0 | 62/63 at 12 mos | 7 stenosis | 0 | 54 of 56 assessed were unchanged; 2 improved |
Food and Drug Administration [20] | 8 | 0 | 1 fatal ICH, 1 femoral pseudoaneurysm, 2 retroperitoneal hematomas | 1 | 5/6 at 6 mos | 0 | Not mentioned | NA |
Total | 447 | 23 | 3 IA ruptures; 14 ischemic events; 11 non-IA-related intracranial hemorrhagic events; 6 worsening of mass effects; 1 unknown nature; 11 puncture-site hematoma | 9 | 319/385 | 21 | 2 | – |
Procedure-Related Complications and Mortalities (Table 2)
Angiographic and Clinical Outcomes (Table 2)
Reference | Number of IAs with previous stenting | Number of complete obliterations | Number of PED-related complications |
---|---|---|---|
McAuliffe et al. [15] | 6 | 3 | 0 |
McAuliffe and Wenderoth [14] | 2 | 2 | 0 |
Fischer et al. [19] | 30 | 20a
| 2 ischemic infarctions; 2 ICHs |
Nelson et al. [17] | 2 | 1 | 1 ischemic infarction |
De Barros Faria et al. [18] | 3 | 2 | 0 |
Lylyk et al. [9] | 7 | 6 | 0 |
Total | 50 | 34 | 5 |