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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Endovascular Treatment for Cavernous Carotid Aneurysms: A Systematic Review and Meta-Analysis
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Endovascular Treatment for Cavernous Carotid Aneurysms: A Systematic Review and Meta-Analysis

机译：海绵状颈动脉瘤的血管内治疗：系统评价和荟萃分析

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Background and purpose: Coiling and flow diversion are established endovascular tech-niques for treatment of cavernous carotid aneurysms (CCAs). We performed a system-atic review of published series on endovascular treatment of CCAs in order to assess the efficacy and safety between coiling and flow diversion. Methods: We conducted a computerized search of PubMed, MEDLINE, and Web of Science electronic databases for reports on endovascular treatment of CCAs from 1990 to 2019. Comparisons were made in complete occlusion rate, improvement of symptoms rate and intraoperative complication rate between coiling and flow diversion. Results: Fourteen studies with 736 patients were included in this systematic review. Five hundred ninety-4 patients underwent coiling, 142 patients underwent flow diversion. The complete occlusion rate in the coiling group was significantly lower than that in the flow division group (odds ratio .37, 95%CI .16-.83, P < .00001), a forest plot did not reveal any significant differences in the improvement of symptoms rate or intraoperative complication rate following coiling and flow diversion. Complete occlusion rate was significantly lower in the coiling group (53%, 95%CI .40-.67) compared with the flow diversion group (74%, 95%CI .55-.94). Improvement of symptoms was significantly lower in the coiling group (54%, 95%CI .46-.63) compared with the flow diversion group (92%, 95%CI .85-.99). Coiling group had lower intraoperative complication rate (9%, 95%CI .06-.12) compared with flow division group (36%, 95%CI .25-.47). Conclusions: Compared with coiling, the use of flow diversion for the treatment of CCAs may increase com-plete occlusion rate, and improvement of symptoms rate, but it also raised intraopera-tive complication rate. Due to the lack of high quality control research, further randomized controlled trials are needed to verify our conclusions.
机译：背景和目的：盘绕和分流是治疗海绵状颈动脉瘤（CCA）的血管内技术。我们对已发表的CCAs血管内治疗系列进行了系统回顾，以评估盘绕和分流之间的有效性和安全性。方法：我们对PubMed、MEDLINE和Web of Science电子数据库进行了计算机化搜索，以获取1990年至2019年间CCAs血管内治疗的报告。比较两种术式的完全闭塞率、症状改善率和术中并发症发生率。结果：本系统回顾包括14项研究，共736例患者。594名患者接受了卷取，142名患者接受了分流。卷取组的完全闭塞率显著低于分流组（优势比为.37，95%可信区间为.16-.83，P<0.00001）。森林图显示，在卷取和分流后症状改善率或术中并发症发生率方面没有任何显著差异。与分流组（74%，95%CI.55-.94）相比，盘绕组的完全闭塞率（53%，95%CI.40-.67）显著降低。与分流组（92%，95%CI.85-.99）相比，卷取组（54%，95%CI.46-.63）的症状改善程度显著降低。与分流组（36%，95%CI.25-.47）相比，盘绕组术中并发症发生率较低（9%，95%CI.06-.12）。结论：与盘绕术相比，采用分流术治疗CCAs可提高完全闭塞率，改善症状率，但也提高了术中并发症的发生率。由于缺乏高质量的对照研究，需要进一步的随机对照试验来验证我们的结论。

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