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Treatment of pediatric intracranial aneurysms: case series and meta-analysis

Junaid T Yasin1,2, Adam N Wallace1, Thomas P Madaelil1

  • 1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA.

Journal of Neurointerventional Surgery
|August 14, 2018
PubMed

Insights

Treatment for pediatric cerebral aneurysms shows comparable outcomes for both endovascular and surgical approaches. This study provides evidence for effective management strategies in children with these vascular conditions.

Area of Science:

  • Neurology
  • Pediatric Neurosurgery
  • Vascular Surgery

Background:

  • Limited outcome data exist for treating pediatric cerebral aneurysms.
  • Guiding treatment choices for pediatric cerebral aneurysms is challenging due to sparse evidence.

Purpose of the Study:

  • To analyze institutional experience with pediatric cerebral aneurysms.
  • To perform a meta-analysis of existing studies on pediatric cerebral aneurysm treatments.
  • To provide evidence-based recommendations for managing pediatric cerebral aneurysms.

Main Methods:

  • Institutional case log review for pediatric cerebral aneurysms.
  • Systematic literature search (PubMed, SCOPUS, EMBASE, Cochrane).
  • Meta-analysis of patient and aneurysm characteristics, management, and outcomes.

Main Results:

  • 42 pediatric patients with 57 aneurysms evaluated locally; 560 patients included in meta-analysis.
  • Comparable favorable outcome rates: endovascular (88.3%) vs. surgical (82.7%) overall (P=0.097).
  • Similar outcomes for ruptured (75% vs. 83%, P=0.357) and unruptured (96% vs. 97%, P=1.000) aneurysms.

Conclusions:

  • Endovascular and surgical treatments offer similar long-term clinical outcomes for pediatric cerebral aneurysms.
  • Evidence supports both approaches for managing pediatric cerebral aneurysms.
Abstract

Keywords:
aneurysmhemorrhagepediatricssubarachnoid

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