TY - JOUR T1 - Endovascular Treatment of Very Small Intracranial Aneurysms: Meta-Analysis JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 862 LP - 867 DO - 10.3174/ajnr.A4651 VL - 37 IS - 5 AU - V.N. Yamaki AU - W. Brinjikji AU - M.H. Murad AU - G. Lanzino Y1 - 2016/05/01 UR - http://www.ajnr.org/content/37/5/862.abstract N2 - BACKGROUND AND PURPOSE: Outcomes of endovascular treatment of very small intracranial aneurysms are still not well-characterized. Recently, several series assessing coil embolization of tiny aneurysms have presented new promising results. Thus, we performed a systematic review and meta-analysis of studies evaluating endovascular treatment of very small intracranial aneurysms.MATERIALS AND METHODS: We conducted a computerized search of Scopus, Medline, and the Web of Science for studies on endovascular treatment of very small (≤3 mm in diameter) intracranial aneurysms published between January 1996 and May 2015. Using a random-effects model, we evaluated clinical and angiographic outcomes.RESULTS: Twenty-two studies with 1105 tiny aneurysms (844 ruptured and 261 unruptured) endovascularly treated were included. Postoperative and long-term complete occlusion was achieved in 85% (95% CI, 78%–90%) and 91% (95% CI, 87%–94%) of aneurysms, respectively. The recanalization rate was 6% (95% CI, 4%–11%) and retreatment occurred in 7% (95% CI, 5%–9%) of cases. Seventy-nine percent (95% CI, 64%–89%) of patients had good neurologic outcome at long-term follow-up. Intraprocedural rupture occurred in 7% (95% CI, 5%–9%) of the coiling procedures, while thromboembolic complications occurred in 4% (95% CI, 3%–6%).CONCLUSIONS: Coil embolization of very small intracranial aneurysms can be performed safely and effectively. In the case of unruptured aneurysms, procedure-related complications are not negligible. Patients and providers should consider such risks when engaged in a shared decision-making process.IAintracranial aneurysm ER -