血流导向装置在血泡样动脉瘤治疗中安全性和有效性的Meta分析

Effect of flow diverter stent treatment on blood blister-like aneurysm and its safety: a Meta-analysis

目的系统分析血流导向装置(FD)治疗血泡样动脉瘤(BBA)的效果。方法计算机检索2008年1月至2017年12月PubMed以及Embases数据库中相关文献,由3名评价员独立筛选、评价文献并提取资料,使用RevMan5.3对相关数据进行分析。结果 14篇回顾性文献被纳入,包括115例120个BBA。Meta分析显示:完全闭塞率为69%,复发率为13%,再出血率为8%;手术相关并发症发生率和病死率分别为29%和11%;长期预后良好率为86%。亚组分析显示,相对于重叠FD支架治疗BBA,单FD支架治疗具有更好的预后(P=0.02),但治愈率和手术相关并发症发生率没有显著差异(P>0.05)。结论 FD治疗BBA是安全和有效的。单FD支架与重叠FD支架相比,具有更好的预后。

Objective To assess of the curative effect of flow diverter（FD） stent on blood blister-like aneurysms（BBAs） and its safety. Methods PubMed and Embase databases were searched for the article related to BBAs treated with FD stent published from January 2008 till December, 2017. Meta analysis of the data was performed by RevMan5.3 software. Results Fourteen retrospective studies which were obtained included 115 patients with 120 BBAs. The rate of complete occlusion of BBAs was 69%. The rate of Recurrence and rebleeding of BBAs were 13% and 8% respectively. The rate of procedure-related complication and mortality were 29%and 11% respectively. The rate of long-term good prognoses was 86%. The rate of good prognoses was significantly higher in the patients with BBAs treated by single FD stent than that in the patients with BBAs treated by overlapped FD stent（P=0.02）. There were in significant differences in the rate of complete occlusion of BBAs and occurrence of the procedure-related complication. Conclusions FD stent is a safe and effective method to treat BBAs. Single FD stent strategy may result in a higher good outcome rate compared to overlapped FD stent strategy.