Safety and efficiency of flow diverters for treating small intracranial aneurysms: A systematic review and meta-analysis

BACKGROUND: We evaluated the safety and efficiency of flow diverters (FDs) in treating small intracranial aneurysms (IAs). MATERIALS AND METHODS: We reviewed the literature published in PubMed and EMBASE. R for Project software was used to calculate the complete aneurysm occlusion rates, procedure-related neurologic mortality, procedure-related neurologic morbidity and procedure-related permanent morbidity. RESULTS: Ten observational studies were included in this analysis. The complete aneurysm occlusion rate was 84.23% (80.34%–87.76%), the procedure-related neurologic mortality was 0.87% (0.29%–1.74%), the procedure-related neurologic morbidity rate was 5.22% (3.62%–7.1%), the intracerebral haemorrhage rate was 1.42% (0.64%–2.49%), the ischemic rate was 2.35% (1.31%–3.68%), the subarachnoid haemorrhage rate was 0.03% (0%–0.32%) and the procedure-related permanent morbidity was 2.41% (0.81%–4.83%). CONCLUSIONS: Treatment of small IAs with FDs may be correlated with high complete occlusion rates and low complication rates. Future long-term follow-up randomized trials will determine the optimal treatment for small IAs.