Outcomes after flow diversion treatment of distal anterior circulation intracranial aneurysms
| Variables | Results of Systematic Review and Meta-Analysis | No. of Articles | Statistic (95% CI) (I2) |
|---|---|---|---|
| Angiographic outcomes | |||
| Rate of successful stent deployment | 422/429 = 97.5% | 29 | (96–98.9) (I2 = 0%) |
| Immediate aneurysm occlusion rate (OKM C–D) | 44/333 = 11.1% | 18 | (6.5–16) (I2 = 55%) |
| Overall long-term aneurysm occlusion rate (OKM C–D) | 295/364 = 82.7% | 28 | (77.4–87.9) (I2 = 52%) |
| Long-term occlusion rate (MCA location) | 163/206 = 78% | 13 | (69–88) (I2 = 73.7%) |
| Long-term occlusion rate (AcomA location) | 91/105 = 88% | 13 | (82–94) (I2 = 0%) |
| Long-term occlusion rate (DACA location) | 41/53 = 82% | 6 | (70.7–90.7) (I2 = 0%) |
| Long-term occlusion rate (FRED device) | 37/53 = 73.8% | 7 | (60.1–87.5) (I2 = 31.7) |
| Long-term occlusion rate (p64 device) | 18/22 = 82% | 2 | (64–98) (I2 = 41.7%) |
| Long-term occlusion rate (PED device) | 143/165 = 87.3% | 13 | (82.4–92.3) (I2 = 0%) |
| Long-term occlusion rate (Surpass device) | 11/14 = 80.9% | 2 | (55.5–98) (I2 = 29.3%) |
| Treatment-related complications and clinical outcomes | |||
| Overall treatment-related complications | 63/410 = 12.5% | 28 | (9–16) (I2 = = 18.8%) |
| Treatment-related complications (MCA location) | 44/231 = 18% | 12 | (12–25) (I2 = 42%) |
| Treatment-related complications (AcomA location) | 14/126 = 8% | 10 | (3–13) (I2 = 0%) |
| Treatment-related complications (DACA location) | 5/53 = 9% | 6 | (5–17) (I2 = 0%) |
| Periprocedural/early complications (within 30 days) | 30/418 = 5.9% | 28 | (3.7–8) (I2 = 0%) |
| Delayed complications (after 30 days) | 35/418 = 6.5% | 28 | (3.4–8.4) (I2 = 20%) |
| Transient complications | 37/418 = 6.7% | 28 | (4.4–9) (I2 = 0%) |
| Permanent complications | 29/418 = 5.4% | 28 | (3.3–7.5) (I2 = 0%) |
| Treatment-related complications (FRED device) | 9/66 = 11.7% | 28 | (3.2–20.3) (I2 = 29%) |
| Treatment-related complications (p64 device) | 3/23 = 12.5% | 2 | (1–26) (I2 = 0%) |
| Treatment-related complications (PED device) | 20/159 = 9.2% | 12 | (4.9–13.5) (I2 = 0%) |
| Treatment-related complications (Silk device) | 2/20 = 8.2% | 3 | (3.2–19.5) (I2 = 0%) |
| Treatment-related mortality | 5/374 = 2.2% | 23 | (0.8–3.7) (I2 = 0%) |
| Overall rate of good neurologic outcome | 290/304 = 97% | 23 | (96–99) (I2 = 0%) |
| Type of complications and location | |||
| Thromboembolic complications | 54/418 = 9.9% | 29 | (7–12.7) (I2 = 6.6%) |
| Thromboembolic complications (MCA location) | 40/239 = 14.6% | 12 | (9–20) (I2 = 33%) |
| Thromboembolic complications (AcomA location) | 10/126 = 6% | 10 | (2–10) (I2 = 0%) |
| Thromboembolic complications (DACA location) | 4/53 = 7% | 6 | (1.5–16) (I2 = 0%) |
| Hemorrhagic complications | 7/418 = 2.6% | 29 | (1.1–4) (I2 = 0%) |
| Premature discontinuation of AT and related ischemic events | 6/418 = 2.8% | 29 | (1.3–4.3) (I2 = 0%) |
Note:—OKM indicates O'Kelly-Marotta scale.