Abstract
E-254 Flow diversion for posterior circulation intracranial aneurysms: a systematic review and meta-analysis
Journal of neurointerventional surgery, Vol.17(Suppl 1), pp.A266-A268
07/01/2025
DOI: 10.1136/jnis-2025-SNIS.369
Abstract
Introduction/PurposePosterior circulation (PC) aneurysms are associated with a higher risk of rupture. Flow diverters (FD) are widely used for intracranial aneurysms, but their role in PC aneurysm is less established. We performed a meta-analysis synthesizes of the current literature to assess the safety and effectiveness of FD for PC aneurysms.Materials and MethodsA systematic search was performed from inception until October 2024. The primary effectiveness outcome was complete-occlusion-rate (COR) defined by the Raymond-Roy and/or O'Kelly-Marotta scales. Primary safety outcomes included thromboembolic events rates following implantation. Secondary outcomes included procedure-related mortality, good functional outcome (GFO), and retreatment. Pool estimates were calculated using a random-effect model. Additionally, we conducted a subgroup analysis of COR stratified by morphology.ResultsForty-two studies involving 1,698 patients with 1,760 PC aneurysm met our inclusion criteria. Of which, 47.6% were in the vertebral artery. Our pooled overall analysis of COR was 72.73% (p<0.0001; I2=67.2%). Our pooled overall analysis of thromboembolic events rate following implantation was 11.70% (p<0.0046; I2=70.5%). Additionally, the pooled mortality rate was 8.07% (p<0.0001; I2=61.5%), retreatment rate was 6.59% (p<0.4260; I2=1%), and the pooled GFO rate was 83.99% (p<0.0001; I2=76%). Subgroup analysis revealed that fusiform-dolichoectatic aneurysms had a COR of 48.29% (p<0.3223; I2=11.7%). (table 1)ConclusionOur results revealed that FD for PC aneurysm achieve generally adequate occlusion rate, except in dolichoectatic-fusiform subtypes. Despite achieving adequate occlusion rates, FD use was associated with higher thromboembolic events, mortality, and retreatment rates, which necessitates careful patient selection.Abstract E-254 Figure 1DisclosuresA. Brito: None. L. Cruz-Criollo: None. M. Galecio-Castillo: None. J. Cespedes: None. M. Zanaty: None. E. Samaniego: 2; C; MicroVention, Medtronic, Rapid Medical, iSchemaview, Cerenovus. N. Abdelhakim: None. A. Wakhloo: 2; C; Stryker, Philips, Cerenovus, Microbot. 4; C; Corvista, Neurostream, Medtronic RIST, Prometheus, InNeuroCo., ThrombX, NovaSignal, Neurofine, Hyperion. R. Hanel: 1; C; Interline Endowment, MicroVention, Stryker. 2; C; Medtronic, Stryker, Cerenovus, MicroVention, Balt, Phenox, Rapid Medical, Q'Apel. S. Ortega-Gutierrez: 1; C; NIH-NINDS: RO1NS127114–01, NIH-NINDS: RO1NS127114–01, NIH-NINDSRO3NS126804, PCORI, Stryker, Medtronic, MicroVention, Methinks.
Details
- Title: Subtitle
- E-254 Flow diversion for posterior circulation intracranial aneurysms: a systematic review and meta-analysis
- Creators
- A Brito - University of IowaL Cruz-Criollo - University of Iowa, NeurologyM Galecio-CastilloJ Cespedes - University of Iowa, NeurologyM Zanaty - University of Iowa Health CareE Samaniego - University of Iowa, Iowa Neuroscience InstituteN Abdelhakim - University of IowaA Wakhloo - Tufts UniversityR Hanel - Baptist Medical Center JacksonvilleS Ortega-Gutierrez - University of Iowa, Radiology
- Resource Type
- Abstract
- Publication Details
- Journal of neurointerventional surgery, Vol.17(Suppl 1), pp.A266-A268
- DOI
- 10.1136/jnis-2025-SNIS.369
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group LTD
- Language
- English
- Date published
- 07/01/2025
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984848119602771
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