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Stent-assisted Coiling vs. Flow Diverter for Treating Blood Blister-like Aneurysms : A Proportion Meta-analysis
Jeongjun Lee1, Do Hyung Kim2, Su Hwan Lee1
1Department of Neurosurgery, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, 27th-gil, Dongguk-ro, Ilsandong-gu, 410-773, Goyang-si, Gyeonggi-do, Korea (Republic of).
Clinical Neuroradiology
|April 11, 2022
Summary
Flow diverters (FD) demonstrate superior long-term occlusion rates and lower recanalization for blood blister-like aneurysms (BBAs) compared to stent-assisted coiling (SAC). Both treatments show similar safety profiles regarding complications and clinical outcomes.
Area of Science:
- Vascular Surgery
- Interventional Neuroradiology
- Neurosurgery
Background:
- Blood blister-like aneurysms (BBAs) present a significant therapeutic challenge due to their rarity and complex nature.
- Endovascular treatment is a promising approach for BBAs, but the optimal technique remains debated.
Approach:
- A proportion meta-analysis was conducted, synthesizing data from 32 published studies (2009-2020) on endovascular management of BBAs.
- Studies included interventions using either stent-assisted coiling (SAC) or flow diverters (FD).
Key Points:
- Flow diverters (FD) achieved a higher long-term complete occlusion rate (89.26%) compared to stent-assisted coiling (SAC) (70.26%).
- FD demonstrated a significantly lower rate of aneurysm recanalization (4.54%) versus SAC (25.38%).
- No significant differences were observed between FD and SAC in terms of mortality, functional outcomes, procedural complications, or rebleeding rates.
Conclusions:
- Flow diverters (FD) offer more favorable angiographic outcomes for blood blister-like aneurysms (BBAs).
- Both FD and SAC exhibit comparable safety profiles concerning complications and clinical outcomes in BBA management.
