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A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms

BACKGROUND: The temporary neck bridging devices represented by Comaneci and Cascade are a type of promising endovascular device for the treatment of intracranial bifurcation or wide-necked aneurysms. This systematic review and meta-analysis aim to assess the efficacy and safety of Comaneci/Cascade d...

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Autores principales: Sun, Bowen, Lan, Shuai, Sawant, Harshal, Li, Yuchen, Ling, Yeping, Zhang, Bohan, Wu, Pei, Wang, Chunlei, Shi, Huaizhang, Xu, Shancai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10560715/
https://www.ncbi.nlm.nih.gov/pubmed/37817943
http://dx.doi.org/10.3389/fnhum.2023.1276681
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author Sun, Bowen
Lan, Shuai
Sawant, Harshal
Li, Yuchen
Ling, Yeping
Zhang, Bohan
Wu, Pei
Wang, Chunlei
Shi, Huaizhang
Xu, Shancai
author_facet Sun, Bowen
Lan, Shuai
Sawant, Harshal
Li, Yuchen
Ling, Yeping
Zhang, Bohan
Wu, Pei
Wang, Chunlei
Shi, Huaizhang
Xu, Shancai
author_sort Sun, Bowen
collection PubMed
description BACKGROUND: The temporary neck bridging devices represented by Comaneci and Cascade are a type of promising endovascular device for the treatment of intracranial bifurcation or wide-necked aneurysms. This systematic review and meta-analysis aim to assess the efficacy and safety of Comaneci/Cascade devices for the treatment of intracranial aneurysms. METHODS: We performed a systematic literature search on articles in PubMed, Embase, and Web of Science that evaluated the efficacy and safety of Comaneci/Cascade devices for endovascular treatment of intracranial aneurysms, based on the Preferred Reporting Items for Systematic Reviews and Meta Analytics (PRISMA) guideline. We extracted the characteristics and treatment related information of patients included in the study, recorded the rate of technical success, procedural related complications, and angiographic outcomes. The angiographic outcome was evaluated based on Raymond Roy classification, and adequate occlusion was defined as Raymond Ray I + II. RESULTS: Nine studies comprising 253 patients with 255 aneurysms were included. Among them, eight studies were conducted in Europe, one study was conducted in the USA. All these studies were retrospective. 206 aneurysms (80.78%) were ruptured. The vast majority of patients with ruptured aneurysms did not receive antiplatelet therapy. The rate of technical success was 97.1% (95% CI, 94.9 to 99.3%, I(2) = 0%). The rate of periprocedural clinical complications was 10.9% (95% CI, 5.4 to 22.1%, I(2) = 54%). The rate of complete occlusion (RR1) and adequate occlusion (RR1 + RR2) on immediate angiography after the procedure were 77.7% (95% CI, 72.7 to 83.2%, I(2) = 35%) and 98% (95% CI, 95.9 to 100%, I(2) = 0%) respectively. The rate of complete occlusion (RR1) and adequate occlusion (RR1 + RR2) on the last follow-up angiography were 81.2% (95% CI, 69.2 to 95.2%, I(2) = 81%) and 93.7% (95% CI, 85.6 to 100%, I(2) = 69%) respectively, with follow-up range from 3 to 18 months. 22/187 (11.76%) cases of aneurysms progressed during the follow-up period. 39/187 (20.86%) cases of aneurysms received additional treatment during the follow-up period. No fatal complications occurred during the treatment. CONCLUSION: The Comaneci/Cascade device can be used as an auxiliary treatment for intracranial aneurysms, with a good occlusion effect, but the incidence of complications still needs to be monitored.
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spelling pubmed-105607152023-10-10 A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms Sun, Bowen Lan, Shuai Sawant, Harshal Li, Yuchen Ling, Yeping Zhang, Bohan Wu, Pei Wang, Chunlei Shi, Huaizhang Xu, Shancai Front Hum Neurosci Human Neuroscience BACKGROUND: The temporary neck bridging devices represented by Comaneci and Cascade are a type of promising endovascular device for the treatment of intracranial bifurcation or wide-necked aneurysms. This systematic review and meta-analysis aim to assess the efficacy and safety of Comaneci/Cascade devices for the treatment of intracranial aneurysms. METHODS: We performed a systematic literature search on articles in PubMed, Embase, and Web of Science that evaluated the efficacy and safety of Comaneci/Cascade devices for endovascular treatment of intracranial aneurysms, based on the Preferred Reporting Items for Systematic Reviews and Meta Analytics (PRISMA) guideline. We extracted the characteristics and treatment related information of patients included in the study, recorded the rate of technical success, procedural related complications, and angiographic outcomes. The angiographic outcome was evaluated based on Raymond Roy classification, and adequate occlusion was defined as Raymond Ray I + II. RESULTS: Nine studies comprising 253 patients with 255 aneurysms were included. Among them, eight studies were conducted in Europe, one study was conducted in the USA. All these studies were retrospective. 206 aneurysms (80.78%) were ruptured. The vast majority of patients with ruptured aneurysms did not receive antiplatelet therapy. The rate of technical success was 97.1% (95% CI, 94.9 to 99.3%, I(2) = 0%). The rate of periprocedural clinical complications was 10.9% (95% CI, 5.4 to 22.1%, I(2) = 54%). The rate of complete occlusion (RR1) and adequate occlusion (RR1 + RR2) on immediate angiography after the procedure were 77.7% (95% CI, 72.7 to 83.2%, I(2) = 35%) and 98% (95% CI, 95.9 to 100%, I(2) = 0%) respectively. The rate of complete occlusion (RR1) and adequate occlusion (RR1 + RR2) on the last follow-up angiography were 81.2% (95% CI, 69.2 to 95.2%, I(2) = 81%) and 93.7% (95% CI, 85.6 to 100%, I(2) = 69%) respectively, with follow-up range from 3 to 18 months. 22/187 (11.76%) cases of aneurysms progressed during the follow-up period. 39/187 (20.86%) cases of aneurysms received additional treatment during the follow-up period. No fatal complications occurred during the treatment. CONCLUSION: The Comaneci/Cascade device can be used as an auxiliary treatment for intracranial aneurysms, with a good occlusion effect, but the incidence of complications still needs to be monitored. Frontiers Media S.A. 2023-09-25 /pmc/articles/PMC10560715/ /pubmed/37817943 http://dx.doi.org/10.3389/fnhum.2023.1276681 Text en Copyright © 2023 Sun, Lan, Sawant, Li, Ling, Zhang, Wu, Wang, Shi and Xu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Human Neuroscience
Sun, Bowen
Lan, Shuai
Sawant, Harshal
Li, Yuchen
Ling, Yeping
Zhang, Bohan
Wu, Pei
Wang, Chunlei
Shi, Huaizhang
Xu, Shancai
A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms
title A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms
title_full A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms
title_fullStr A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms
title_full_unstemmed A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms
title_short A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms
title_sort systematic review and meta-analysis of comaneci/cascade temporary neck bridging devices for the treatment of intracranial aneurysms
topic Human Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10560715/
https://www.ncbi.nlm.nih.gov/pubmed/37817943
http://dx.doi.org/10.3389/fnhum.2023.1276681
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