文献类型：期刊文献

英文题名：Efficacy of pipeline embolization device vs. traditional coils in embolization of intracranial aneurysms: A systematic review and meta-analysis

作者：Li, Wei[1,2,3];Xiao, Zaixing[1,2,3];Zhao, Kaixuan[2,3];Yang, Shijie[2,3];Zhang, Yichuan[2,3];Li, Bin[2,3];Zhou, Yu[3,4];Ma, Yong[2,3];Chai, Erqing[2,3]

第一作者：李伟;Li, Wei

通信作者：Chai, ER[1];Chai, ER[2]

机构：[1]Gansu Univ Chinese Med, Clin Med Coll 1, Lanzhou, Peoples R China;[2]Gansu Prov Peoples Hosp, Cerebrovasc Dis Ctr, Lanzhou, Peoples R China;[3]Key Lab Cerebrovasc Dis Gansu Prov, Lanzhou, Peoples R China;[4]Lanzhou Univ, Clin Med Coll 1, Lanzhou, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Prov Peoples Hosp, Cerebrovasc Dis Ctr, Lanzhou, Peoples R China;[2]corresponding author), Key Lab Cerebrovasc Dis Gansu Prov, Lanzhou, Peoples R China.

年份：2022

卷号：13

外文期刊名：FRONTIERS IN NEUROLOGY

收录：;Scopus(收录号：2-s2.0-85140009511);WOS:【SCI-EXPANDED(收录号:WOS:000868640500001)】；

语种：英文

外文关键词：PED vs. traditional coils efficacy pipeline embolization device(PED); traditional coils; intracranial aneurysm; comparative efficacy; systematic review; meta-analysis

摘要：Introduction: In recent years, the Pipeline embolization device (PED) has been widely used in the embolization of intracranial aneurysms, but there are some inconsistent findings on whether its efficacy and safety are superior to those of traditional coils embolization (coils alone, stent-assisted coils and balloon-assisted coils). The purpose of this meta-analysis was to evaluate the safety and efficacy of PED in intracranial aneurysm embolization by comparing with traditional coils. Methods: We systematically searched PubMed, Embase, Web of Science, and The Cochrane Library databases for randomized controlled trials and observational studies (case-control studies and cohort studies) comparing the efficacy of PED with traditional coils in intracranial aneurysm embolization published before April 1, 2022. The endpoints observed in this meta-analysis were procedure-related intracranial hemorrhage, procedure-related intracranial ischemia, other procedure-related complications (e.g., aneurysm rupture, neurological impairment, etc.), retreatment rate, complete occlusion (100%) of the aneurysm at the last follow-up, and favorable functional outcome (MRS <= 2). Results: A total of 10 studies with a total of 1,400 patients (PED group: 576 and Traditional coils: 824) were included in this meta-analysis. A comprehensive analysis of the included literature showed that the PED group had a higher rate of complete aneurysm occlusion [OR = 2.62, 95% Cl (1.94, 3.55), p < 0.00001] and Lower re-treatment rate [OR = 0.20, 95% Cl (0.12, 0.34 p < 0.00001)] compared with the traditional coil embolization group at the last follow-up. In terms of procedure-related intracranial hemorrhage [OR = 3.04, 95% Cl (1.08, 8.57), p = 0.04] and other procedure-related complications [OR = 2.91, 95% Cl (1.48, 5.57), p = 0.002], the incidence of PED was higher than that of the traditional coil embolization group. Moreover, in terms of favorable functional outcome [OR = 0.4, 95% Cl (0.22, 0.71), p = 0.002] of patients at the last follow-up, the PED group was lower than the traditional coil embolization group. There was no statistically significant between the two groups in terms of surgery-related intracranial ischemia complications [OR = 0.88, 95% Cl (0.47, 1.64), p = 0.68]. Conclusion: PED had higher rates of complete aneurysm occlusion and lower rates of aneurysm retreatment compared with traditional coils, but traditional coils was superior to the PED group in terms of procedure-related intracranial hemorrhage complication and other procedure-related complications (aneurysm rupture, neurological impairment), and favorable functional outcome (mRS & LE; 2). This result still needs to be further confirmed by additional large-sample, multicenter, prospective randomized controlled trials.