Journal of neurointerventional surgery
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Review Meta Analysis
Middle meningeal artery embolization for chronic subdural hematoma: a systematic review and meta-analysis.
Middle meningeal artery (MMA) embolization has been proposed as a minimally invasive treatment for chronic subdural hematoma (cSDH). The aim of this systematic review and meta-analysis is to compare outcomes after MMA embolization versus conventional management for cSDH. We performed a systematic review of PubMed, Embase, Oxford Journal, Cochrane, and Google Scholar databases from April 1987 to October 2020 in accordance with PRISMA guidelines. ⋯ In-hospital complication rates were comparable between the two cohorts (OR=0.78 (0.34 to 1.76), p=0.55). MMA embolization is a promising minimally invasive therapy that may reduce the need for surgical intervention in appropriately selected patients with cSDH. Additional prospective studies are warranted to determine the long-term durability of MMA embolization, refine eligibility criteria, and establish this endovascular approach as a viable definitive treatment for cSDH.
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The objective of this meta-analysis was to establish safety and effectiveness benchmarks for endovascular therapy of unruptured small-to-medium internal carotid artery (ICA) aneurysms using flow diverters. ⋯ The treatment of small and medium-sized aneurysms with flow diverters is effective in achieving curative reconstruction in most cases and is associated with low rates of morbidity and mortality. This meta-analysis informs robust performance goals for evaluating new flow diverters in small/medium unruptured carotid aneurysms.
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To compare the safety and efficiency of stent assisted coiling (SAC) with non-SAC for the management of ruptured intracranial aneurysms. ⋯ SAC has a lower recurrence rate than non-SAC. Nevertheless, further validation by well designed prospective studies is warranted for determining whether stents improve angiographic outcome without an increased complication rate or unfavorable clinical outcome.
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Meta Analysis
Meta-analysis of treatment outcomes of posterior circulation non-saccular aneurysms by flow diverters.
Non-saccular aneurysms of the posterior circulation are uncommon but highly dangerous lesions. Flow diverter stents have been demonstrated to be effective treatments of various anterior circulation aneurysms, particularly large and giant proximal internal carotid artery aneurysms. However, evidence regarding the treatment of non-saccular posterior circulation aneurysms with flow diverters is lacking. ⋯ Flow diversion is a feasible and efficacious treatment for non-saccular aneurysms in the posterior circulation. However, the intervention carries a significant risk of periprocedural stroke, and is still associated with high overall mortality. Further studies are needed to identify significant treatment risk factors and optimize patient selection.
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Review Meta Analysis
Impact of balloon guide catheter on technical and clinical outcomes: a systematic review and meta-analysis.
Flow arrest with balloon guide catheters (BGCs) is becoming increasingly recognized as critical to optimizing patient outcomes for mechanical thrombectomy. We performed a systematic review and meta-analysis of the literature for studies that compared angiographic and clinical outcomes for patients who underwent mechanical thrombectomy with and without BGCs. ⋯ Non-randomized studies suggest that BGC use during mechanical thrombectomy for acute ischemic stroke is associated with superior clinical and angiographic outcomes. Further randomized trials are needed to confirm the results of this study.