Marcelo Porto Sousa, Guilherme Nunes Marques, Livia Abreu, Filipi Fim Andreão, Leonardo Oliveira, Gabriel Verly, Sávio Batista, Guilherme Melo Silva, Raphael Muszkat Besborodco, Raphael Bertani
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引用次数: 0
摘要
导言：宽颈动脉瘤给血管内神经外科医生带来了严峻的挑战。因此，MicroVention-Terumo 公司生产的低位可视化腔内支架 Junior (LVIS Jr) 成为一种很有前景的治疗方案。本荟萃分析旨在评估该技术在治疗宽颈动脉瘤方面的可用性和有效性：方法：我们在 PubMed、Embase 和 Web of Science 数据库中进行了系统检索，其中包括与 LVIS Jr 用于宽颈动脉瘤的结果相关的研究。从所选文章中提取数据并进行统计分析。此外，还采用 ROBINS-I 工具进行质量评估：在初步确定的 886 篇文章中，有 20 项研究符合我们的纳入标准，共纳入 557 名患者。我们的分析显示，共同效应下的最终闭塞率为 96%，随机效应下为 93%，异质性很大（I² = 69%），99% 的病例临床疗效良好，异质性较低（I² = 27%）。死亡率极低，18 项研究的 499 名患者中仅有一人死亡，在共同效应和随机效应下死亡率为 0%，且无异质性（I² = 0）。482例患者中有44例出现并发症，在共同效应模型中并发症发生率为6%，在随机效应模型中并发症发生率为6%，异质性不显著（I² = 25%）：结论：LVIS Jr 的最终闭塞率较高，临床效果良好。此外，低死亡率和并发症发生率也凸显了其安全性。
Efficacy and Safety Assessment of LVIS Jr Device in Treating Wide-Neck Aneurysms: A Comprehensive Systematic Review and Single-Arm Meta-Analysis.
Aim: To evaluate the usage and the effectiveness of LVIS Jr device technology in managing wide-neck intracranial aneurysms.
Material and methods: PubMed, Embase, and Web of Science databases, comprising studies with outcomes related to LVIS Jr use in wide-neck intracranial aneurysms were searched systematically. Data was extracted from the selected articles and subjected to statistical analysis.
Results: Among 886 initially identified articles, 20 studies met our inclusion criteria, comprising a total of 557 patients. Our analysis revealed a 96% final occlusion rate under common effects and 93% under random effects, with substantial heterogeneity (I² = 69%). Good clinical outcomes were observed in 99% of cases with low heterogeneity (I² = 27%). Mortality rates were extremely low, with only one reported death out of 499 patients across 18 studies, resulting in a 0% mortality rate for common and random effects and no heterogeneity (I² = 0). Complications occurred in 44 of 482 patients, yielding a 6% rate in the common effect model and 6% in the random effects model, with nonsignificant heterogeneity (I² = 25%).
Conclusion: LVIS Jr observed a favorable rate of final occlusion and good clinical outcomes, and the low mortality and complication rates highlight its safety in the treatment of wide-neck aneurysms.
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