Long-term outcomes of flow diversion for unruptured intracranial aneurysms: a systematic review and meta-analysis

Mostafa A. Shehata, Mohamed K. Ibrahim, Sherief Ghozy, Cem Bilgin, Mohamed Sobhi Jabal, Ramanathan Kadirvel, David F. Kallmes

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Flow diverters have been widely used in clinical practice for more than a decade. However, most outcome data are limited to 1 year timepoints. This study aims to offer meta-analysis data on long-term (>1 year) safety and effectiveness results for patients with aneurysms treated with flow diverters. Methods: PubMed, Web of Science, Embase, and SCOPUS were searched up to February 24, 2022 using the AutoLit platform. We included primary studies assessing the long-term outcomes for flow diverter devices to manage unruptured internal carotid artery aneurysms with a follow-up period of >1 year. The meta-analysis was carried out using Comprehensive Meta-Analysis software (CMA). Results: Eleven studies were included in the meta-analysis. The pooled occlusion rates after flow diversion treatment for unruptured intracranial brain aneurysms were 77%, 87.4%, 84.5%, 89.4%, 96% for 1 year, 1-2 years, 2 years, 3 years, and 5 years follow-up, respectively. The in-stent stenosis rate was 4.8% and the retreatment rate for the long-term follow-up period was 5%. No delayed rupture of the aneurysm was reported, and there was one case of delayed ischemic stroke. The sensitivity analysis of the prospective studies showed a complete occlusion rate of 83.5% and 85.2% for 1 and 3 years of follow-up, respectively. Conclusion: Flow diverters are safe and effective in short- and long-term follow-up and rarely cause serious delayed side effects.

Original languageEnglish (US)
Article numberA821
JournalJournal of neurointerventional surgery
DOIs
StateAccepted/In press - 2022

Keywords

  • aneurysm

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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