在破裂和未破裂的内动脉瘤中使用支架辅助或非支架辅助的线圈:元分析和系统审查
Fardin Nabizadeh1,2, Parya Valizadeh3, Mohammad Balabandian1,2
1Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
World neurosurgery: X
|January 15, 2024
概括
内动脉瘤的支架辅助卷曲 (SAC) 与非支架辅助卷曲 (非SAC) 相比,显示复发率较低,但并发症风险更高. 需要进一步的研究,以指导破裂和未破裂动脉瘤的最佳治疗策略.
科学领域:
- 神经外科 神经外科
- 干预神经病学 干预神经病学
- 医疗技术 医疗技术 医学技术
背景情况:
- 内动脉瘤需要不同的内血管和非侵入性治疗.
- 支架辅助卷轴 (SAC) 和非支架辅助卷轴 (非SAC) 是关键的卷轴技术.
- 之前关于SAC与非SAC疗效和安全性的研究产生了有争议的结果.
研究的目的:
- 与非SAC相比,系统地审查和元分析SAC的疗效和安全性.
- 根据动脉瘤状态进行分层比较:破裂和未破裂.
主要方法:
- 在PubMed,Scopus,Web of Science和Cochrane控制试验中央注册表中进行了全面的文献搜索.
- 包括26项研究进行定性和定量综合.
- 系统审查和元分析比较SAC和非SAC技术.
主要成果:
- 在所有动脉瘤类型中,包括未破裂 (RR:0.63),破裂 (RR:0.29) 和组合 (RR:0.42) 的动脉瘤中,SAC显示出明显较低的复发率 (RR:0.43).
- 在未破裂的动脉瘤中,观察到使用SAC的过程内破裂的风险更高 (RR: 1.40).
- 出血事件的风险在破裂 (RR: 1.73) 和组合动脉瘤 (RR: 0.60) 中显著不同,在即时/完全封闭或缺血事件中没有显著差异.
结论:
- 在动脉瘤复发方面,SAC可以提供更好的疗效.
- SAC与某些并发症的风险增加有关,例如手术内破裂.
- 进一步的随机对照试验是必要的,以优化对内动脉瘤的卷积策略的选择.
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