Endovascular treatment of ruptured middle cerebral artery aneurysms: a single armed meta-analysis and systematic review.

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Endovascular treatment of ruptured middle cerebral artery aneurysms: a single armed meta-analysis and systematic review.

World Neurosurg. 2019 Jan 24;:

Authors: Zhang X, Zhou Y, Duan G, Tang H, Zuo Q, Yang P, Xu Y, Hong B, Huang Q, Liu J

Abstract
OBJECTIVE: Endovascular treatment for ruptured middle cerebral artery (MCA) aneurysms, which were more likely to be recommended for neurosurgical clipping because of complex anatomic configuration, still remain controversial. In this study, angiographic and clinical outcomes ofendovacularly treated ruptured MCA aneurysms were systematically reviewed.
MATERIALS AND METHODS: Online database including Cochrane, Medline, web of science and Embase were retrospectively and systematically searched. The primary outcomes were immediate complete occlusion rate, mortality, complication-related mortality and procedure-related complication rate. Meta-analysis was performed using random or fixed effect model based on heterogeneity.
RESULTS: A total of 14 articles were included with 1004 ruptured MCA aneurysms. Procedure-related mortality rate at discharge was 1.8% (95% CI: 0.9%∼2.7%; I2=0.0%; P=0.623). The favorable clinical outcome rate at discharge was 65.4% (95% CI: 54.8%∼76.0%; I2=94.2%; P<0.001) and progressively raised to 73.2% (95% CI: 59.9%∼86.5%; I2=80.9%; P<0.001). The overall complication rate was 22.7% (95% CI: 15.1%∼30.3%; I2=75.5%; P<0.001).
CONCLUSION: Endovascular treatment of MCA aneurysms was related with a high incidence of procedure-related complication but a low rate of procedure-related mortality. The overall angiographic and clinical outcome was comparable and warranted further investigations comparing clipping versus coiling for ruptured MCA aneurysms.

PMID: 30685370 [PubMed - as supplied by publisher]

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