Diffusion-weighted imaging lesions after endovascular treatment of cerebral aneurysms: A network meta-analysis

作者全名："Mo, Lijuan; Yue, Jianhe; Yu, Wanli; Liu, Xi; Tan, Changhong; Peng, Wuxue; Ding, Xueying; Chen, Lifen"

作者地址："[Mo, Lijuan; Liu, Xi; Tan, Changhong; Peng, Wuxue; Chen, Lifen] Chongqing Med Univ, Affiliated Hosp 2, Dept Neurol, Chongqing, Peoples R China; [Yue, Jianhe; Yu, Wanli] Chongqing Med Univ, Affiliated Hosp 2, Dept Neurosurg, Chongqing, Peoples R China; [Ding, Xueying] Shenzhen Univ, Dept Neurol, Gen Hosp, Shenzhen, Peoples R China"

通信作者："Chen, LF (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Neurol, Chongqing, Peoples R China."

来源：FRONTIERS IN SURGERY

ESI学科分类：　

WOS号：WOS:000921554000001

JCR分区：Q2

影响因子：1.8

年份：2023

卷号：9

期号：　

开始页：　

结束页：　

文献类型：Review

关键词：intracranial aneurysms; intravascular devices; thromboembolism; diffusion-weighted imaging; treatment

摘要："BackgroundThromboembolism is one of the common complications in endovascular treatments including coiling alone, stent-assisted coiling (SAC), balloon-assisted coiling (BAC), and flow-diverting (FD) stents. Such treatments are widely used in intracranial aneurysms (IAs), which usually present as positive lesions in diffusion-weighted imaging (DWI). Whether these adjunctive techniques increase postprocedural DWI-positive lesions after endovascular treatment remains unclear. MethodsA thorough electronic search for the literature published in English between January 2000 and October 2022 was conducted on PubMed, Medline, and EMBASE. Eighteen studies (3 cohort studies and 15 case-control studies) involving 1,843 patients with unruptured IAs (UIAs) were included. We performed a frequentist framework network meta-analysis (NMA) to compare the rank risks of cerebral thromboembolism of the above four endovascular treatments. The incoherence test was used to analyze the statistical disagreement between direct and indirect evidence. Funnel plots were used to analyze publication bias. ResultsThe incidences of DWI lesions in patients who received FD stents, SAC, BAC, and coiling alone were 66.1% (109/165), 37.6% (299/795), 31.1% (236/759), and 25.6% (236/921). The incidence of DWI lesions in patients who received FD stents was higher than that in patients who received SAC [OR: 2.40; 95% CI (1.15, 5.00), P < 0.05], BAC [OR: 2.62; 95% CI (1.19, 5.77), P < 0.05], or coiling alone [OR: 2.77; 95% CI (1.26, 6.07), P < 0.05]. The incoherence test showed preferable consistency in this NMA. No obvious publication bias was found in the funnel plot. ConclusionFD stent placement brings more ischemic lesions identified by DWI than any other procedures for patients with UIA. The characteristics of FD stents may result in a high incidence of DWI lesions."

基金机构："National Natural Science Foundation of China; Kuanren talent program of the Second Affiliated Hospital of Chongqing Medical University [81771391, 82001367]"

基金资助正文：This work was funded by the National Natural Science Foundation of China and the Kuanren talent program of the Second Affiliated Hospital of Chongqing Medical University (grant nos. 81771391 and 82001367).