医学
动脉瘤
栓塞
分流器
闭塞
系统回顾
荟萃分析
外科
死亡率
放射科
梅德林
内科学
政治学
法学
作者
André Monteiro,Samantha M Burke,Ammad A Baig,Slah Khan,Justin M Cappuzzo,Muhammad Waqas,Joseph E Dietrich,Elad I. Levy,Adnan H. Siddiqui
标识
DOI:10.1136/neurintsurg-2021-018390
摘要
Surface-modified flow diverters (FDs) designed to reduce thrombogenicity represent the next frontier for intracranial aneurysm treatment. The Derivo Embolization Device (DED) is a novel FD with titanium oxide and titanium oxynitride finishing of the struts. We performed a systematic review of pertinent literature, aiming to evaluate the device's effectiveness and safety.A literature search of PubMed, Embase, and MEDLINE was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Five studies comprising 481 aneurysms were included. These studies were conducted in Turkey, Brazil, Germany, Poland, and Italy; two were prospective and three were retrospective. Twenty-six aneurysms (5.4%) were ruptured. The antiplatelet regimens were heterogeneous, but dual antiplatelet therapy was administered preprocedurally in all studies and maintained for 3-12 months before a switch to single antiplatelet therapy. The rate of periprocedural ischemic and hemorrhagic complications was 4.9% (95% CI 2.9% to 7%). Adjunctive coiling was used in 25.6% (95% CI 11.4% to 39.8%) of aneurysms. The complete angiographic occlusion rate was 81.4% (95% CI 71.3% to 91.5%), mortality rate was 2.1% (95% CI 0.4% to 3.9%), with follow-up ranging from 9 to 18 months. Delayed aneurysm rupture was reported in one patient.The DED has been increasingly used in other countries. We identified low rates of periprocedural complications and mortality and a high rate of complete occlusion.
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