Flow-diverting device versus coil embolization for unruptured intracranial aneurysm: A meta-analysis.

BACKGROUND: Both coil embolization (CE) and flow-diverting device (FDD) placement are widely used for treatment of intracranial aneurysms (IAs). The aim of this meta-analysis is to compare the relative clinical safety and efficacy of FDD and CE for the treatment of unruptured IAs. METHODS: The PubMed, Embase, and Cochrane Library databases were searched for relevant studies from the date of inception through April 2020. The primary endpoint for this meta-analysis was the 6-month rate of complete occlusion, while secondary endpoints included rates of retreatment, complications, and parental arterial patency. RESULTS: This meta-analysis includes 8 studies, which included 839 total patients that underwent FDD and 2734 that underwent CE. FDD group exhibited a significantly higher pooled 6-month complete occlusion rate (P = .02). The subgroup analysis demonstrated that FDD treatment was associated with significantly higher pooled 6-month complete occlusion rates in patients with large or giant IAs (P < .00001), whereas no differences in 6-month complete occlusion rates were observed between the FDD and CE groups of patients with non-large/giant IAs (P = .83). The pooled retreatment (P = .16) and complication (P = .15) rates were comparable between 2 groups. The CE group exhibited significantly higher pooled parent artery patency rate (P = .01). The funnel plots did not reveal any evidence of publication bias. CONCLUSIONS: FDDs can be used to effectively and safely treat large and giant IAs, achieving higher rates of complete occlusion than CE treatment. For non-large/giant IAs, we observed comparable efficacy between FDD and CE treatments.

Treatment of superior mesenteric artery embolism by percutaneous mechanica thrombectomy with the Solitaire FR stent system / 中国实用外科杂志

OBJECTIVE: To evaluate the technical feasibility,safety,and clinical outcome of mechanical thrombectomy with Solitaire FR stent system for embolic occlusion of the superior mesenteric artery(SMA).METHODS: The clinical data of 6 patients with embolic occlusion of the SMA treated by mechanical thrombectomy with Solitaire FR stent system between January 2015 and June 2018 in Binzhou City People's Hospital were analyzed retrospectively.RESULTS: Superior mesenteric artery occlusion was initially diagnosed by computed tomography(CT)in all patients.A successful thrombus removal of superior mesenteric arterial by Solitaire FR stent system was observed in the 6 patients.Five patients had recovered well after operation and no complications such as artery dissection,perforation and hemorrhage or intestinal ischemia.One patient underwent bowel resection.CONCLUSION: The arterial mechanical thrombectomy with solitaire FR stent system are characterized with high rate of recanalization,fine security,minimal invasion and less complications in patients with acute superior mesentericvarterial embolism.