Mohammad Amin Dabbagh Ohadi, Seyyed Amir Asef, Raha Zamani, Mohammad Dashtkoohi, Basel Musmar, Ali Zomorodi, David Hasan
{"title":"编织 EndoBridge 装置作为颅内分叉动脉瘤支架辅助夹闭术的良好替代治疗方法:系统综述和荟萃分析。","authors":"Mohammad Amin Dabbagh Ohadi, Seyyed Amir Asef, Raha Zamani, Mohammad Dashtkoohi, Basel Musmar, Ali Zomorodi, David Hasan","doi":"10.1007/s10143-024-03016-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The Woven EndoBridge (WEB), functioning as an intrasaccular disruption device, offers a novel option for complex aneurysms, particularly bifurcation aneurysms. In this systematic review and meta-analysis, our goal is to compare the safety and efficacy of WEB devices with stent-assisted coiling (SAC) for intracranial bifurcation aneurysms.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Scopus, and Embase, and Web of Science databases in September 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We aimed to compare aneurysmal occlusion, procedural time, the retreatment, and complication rates as secondary objectives. The comparison between the two techniques was performed using a weighted random-effects model, and the quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies.</p><p><strong>Results: </strong>The authors analyzed five studies encompassing 298 and 203 patients in SAC and WEB groups, respectively. Complete (OR, 0.97; 95%CI: 0.63-1.49, I<sup>2</sup> = 0%) and adequate (OR: 0.88; 95%CI: 0.51-1.5, I<sup>2</sup> = 0%) occlusion didn't differ between two groups. The overall procedural time mean difference was 38.2 min, significantly higher in the SAC group (95%CI, 26.9-49.6, I<sup>2</sup> = 53.4%). Retreatment rates did not significantly differ between the two groups (OR: 1.34; 95%CI: 0.37-4.85, I<sup>2</sup> = 61.7%). The SAC group experienced more complications during and after the operation (OR, 2.82; 95%CI: 1.07-7.44, I<sup>2</sup> = 0%). The pooled follow-up duration was 22.1 and 13.5 months for SAC and WEB groups respectively.</p><p><strong>Conclusion: </strong>The WEB demonstrates comparable efficacy in occluding bifurcation aneurysms compared to SAC, with the added benefits of reduced procedural time and lower complication rates.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"825"},"PeriodicalIF":2.5000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Woven EndoBridge device as a good alternative treatment for stent assisted coiling in intracranial bifurcation aneurysms: a systematic review and meta-analysis.\",\"authors\":\"Mohammad Amin Dabbagh Ohadi, Seyyed Amir Asef, Raha Zamani, Mohammad Dashtkoohi, Basel Musmar, Ali Zomorodi, David Hasan\",\"doi\":\"10.1007/s10143-024-03016-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The Woven EndoBridge (WEB), functioning as an intrasaccular disruption device, offers a novel option for complex aneurysms, particularly bifurcation aneurysms. In this systematic review and meta-analysis, our goal is to compare the safety and efficacy of WEB devices with stent-assisted coiling (SAC) for intracranial bifurcation aneurysms.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Scopus, and Embase, and Web of Science databases in September 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We aimed to compare aneurysmal occlusion, procedural time, the retreatment, and complication rates as secondary objectives. The comparison between the two techniques was performed using a weighted random-effects model, and the quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies.</p><p><strong>Results: </strong>The authors analyzed five studies encompassing 298 and 203 patients in SAC and WEB groups, respectively. Complete (OR, 0.97; 95%CI: 0.63-1.49, I<sup>2</sup> = 0%) and adequate (OR: 0.88; 95%CI: 0.51-1.5, I<sup>2</sup> = 0%) occlusion didn't differ between two groups. The overall procedural time mean difference was 38.2 min, significantly higher in the SAC group (95%CI, 26.9-49.6, I<sup>2</sup> = 53.4%). Retreatment rates did not significantly differ between the two groups (OR: 1.34; 95%CI: 0.37-4.85, I<sup>2</sup> = 61.7%). The SAC group experienced more complications during and after the operation (OR, 2.82; 95%CI: 1.07-7.44, I<sup>2</sup> = 0%). The pooled follow-up duration was 22.1 and 13.5 months for SAC and WEB groups respectively.</p><p><strong>Conclusion: </strong>The WEB demonstrates comparable efficacy in occluding bifurcation aneurysms compared to SAC, with the added benefits of reduced procedural time and lower complication rates.</p>\",\"PeriodicalId\":19184,\"journal\":{\"name\":\"Neurosurgical Review\",\"volume\":\"47 1\",\"pages\":\"825\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-10-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurosurgical Review\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10143-024-03016-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurosurgical Review","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10143-024-03016-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:Woven EndoBridge(WEB)作为一种肌内破坏装置,为复杂动脉瘤,尤其是分叉动脉瘤提供了一种新的选择。在这篇系统综述和荟萃分析中,我们的目标是比较 WEB 装置和支架辅助卷曲(SAC)治疗颅内分叉动脉瘤的安全性和有效性:2024年9月,我们按照系统综述和Meta分析首选报告项目(PRISMA)指南,对PubMed、Scopus、Embase和Web of Science数据库进行了系统检索。我们的次要目标是比较动脉瘤闭塞、手术时间、再治疗和并发症发生率。两种技术之间的比较采用加权随机效应模型,研究质量采用纽卡斯尔-渥太华量表(NOS)对队列研究进行评估:作者分析了五项研究,分别涉及 SAC 组和 WEB 组的 298 名和 203 名患者。完全闭塞(OR,0.97;95%CI:0.63-1.49,I2 = 0%)和充分闭塞(OR:0.88;95%CI:0.51-1.5,I2 = 0%)在两组之间没有差异。总体手术时间的平均差异为38.2分钟,SAC组明显高于SAC组(95%CI:26.9-49.6,I2 = 53.4%)。两组的再治疗率无明显差异(OR:1.34;95%CI:0.37-4.85,I2 = 61.7%)。SAC组在术中和术后出现的并发症较多(OR:2.82;95%CI:1.07-7.44,I2 = 0%)。SAC组和WEB组的综合随访时间分别为22.1个月和13.5个月:结论:与 SAC 相比,WEB 在闭塞分叉动脉瘤方面的疗效相当,而且手术时间更短,并发症发生率更低。
The Woven EndoBridge device as a good alternative treatment for stent assisted coiling in intracranial bifurcation aneurysms: a systematic review and meta-analysis.
Objectives: The Woven EndoBridge (WEB), functioning as an intrasaccular disruption device, offers a novel option for complex aneurysms, particularly bifurcation aneurysms. In this systematic review and meta-analysis, our goal is to compare the safety and efficacy of WEB devices with stent-assisted coiling (SAC) for intracranial bifurcation aneurysms.
Methods: We conducted a systematic search of PubMed, Scopus, and Embase, and Web of Science databases in September 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We aimed to compare aneurysmal occlusion, procedural time, the retreatment, and complication rates as secondary objectives. The comparison between the two techniques was performed using a weighted random-effects model, and the quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies.
Results: The authors analyzed five studies encompassing 298 and 203 patients in SAC and WEB groups, respectively. Complete (OR, 0.97; 95%CI: 0.63-1.49, I2 = 0%) and adequate (OR: 0.88; 95%CI: 0.51-1.5, I2 = 0%) occlusion didn't differ between two groups. The overall procedural time mean difference was 38.2 min, significantly higher in the SAC group (95%CI, 26.9-49.6, I2 = 53.4%). Retreatment rates did not significantly differ between the two groups (OR: 1.34; 95%CI: 0.37-4.85, I2 = 61.7%). The SAC group experienced more complications during and after the operation (OR, 2.82; 95%CI: 1.07-7.44, I2 = 0%). The pooled follow-up duration was 22.1 and 13.5 months for SAC and WEB groups respectively.
Conclusion: The WEB demonstrates comparable efficacy in occluding bifurcation aneurysms compared to SAC, with the added benefits of reduced procedural time and lower complication rates.
期刊介绍:
The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.