PT  - JOURNAL ARTICLE
AU  - A. Scerrati
AU  - J. Visani
AU  - M.E. Flacco
AU  - L. Ricciardi
AU  - S. Trungu
AU  - A. Raco
AU  - F. Dones
AU  - P. De Bonis
AU  - C.L. Sturiale
TI  - Endovascular Treatment of Ruptured Intracranial Blister Aneurysms: A Systematic Review and Meta-analysis
AID  - 10.3174/ajnr.A6924
DP  - 2021 Mar 01
TA  - American Journal of Neuroradiology
PG  - 538--545
VI  - 42
IP  - 3
4099  - http://www.ajnr.org/content/42/3/538.short
4100  - http://www.ajnr.org/content/42/3/538.full
SO  - Am. J. Neuroradiol.2021 Mar 01; 42
AB  - BACKGROUND: Endovascular treatment of blister aneurysms is a promising approach, even though they are vascular lesions challenging to treat due to their angioarchitectural characteristics.PURPOSE: Our aim was to investigate clinical and radiologic outcomes after endovascular treatment of ruptured blister aneurysms.DATA SOURCES: PubMed, Ovid MEDLINE, Ovid EMBASE, Scopus, and the Web of Science were screened.STUDY SELECTION: We performed a comprehensive review of the literature from 2010 to 2019 reporting series of patients with blister aneurysms treated with an endovascular approach.DATA ANALYSIS: Event rates were pooled across studies using a random effects meta-analysis.DATA SYNTHESIS: A total of 32 studies reporting on 684 patients (707 aneurysms) were included. Stent placement, stent-assisted coiling, and flow diversion were the most commonly described treatments (282, 256, and 155 patients, respectively). The long-term complete occlusion rate was 76.9% (95% CI, 69.2%–83.9%). The perioperative complication rate was 8.9%, and clinical outcome at final follow-up was mRS <2 in 76.6% (95% CI, 68.2%–84.2%) of patients. The mortality rate was 4.7% (95% CI, 2.30%–7.80%). Among the different techniques, stent-assisted coiling is the one that had the higher rate of immediate occlusion (63.4%); however, the occlusion rate at the final follow-up was comparable among the different techniques.LIMITATIONS: Different techniques were described and data were reported in a nonhomogeneous way, possibly representing a bias in the present study.CONCLUSIONS: This study suggests that endovascular treatment of blister aneurysms is associated with good long-term occlusion rates and reasonable complication and mortality rates. There is no consensus on the best endovascular techniques in blister aneurysm management.HHHunt and Hess