The safety and efficiency of SMART coil for brain aneurysm: A systematic review and meta-analysis

Background The SMART coil system is a relatively new generation of embolic coils consisting of a bare platinum coil, a detachment pusher, and a detachment handle. This study investigated the safety and efficiency of the SMART coil system in treating cerebral aneurysms. Method PubMed/Medline, Embase, Web of Science, and Scopus were searched until October, 1st 2023. Non-English language, non-human studies, and non-original studies were excluded. Results A total of 7 studies were included. The results of our study reflected complete aneurysm occlusion (mRRC1) rate of 45% (95% CI, 0.35–0.56), neck remnant aneurysm (mRRC2) rate of 36% (95% CI, 0.30–0.42), and residual aneurysm (mRRC3) rate of 22% (95% CI, 0.12–0.38) during post-procedural assessment. Moreover, considering longest follow-up, our study showed complete aneurysm occlusion (mRRC1) rate of 66% (95% CI, 0.43–0.84), neck remnant aneurysm (mRRC2) rate of 27% (95% CI, 0.13–0.49), and residual aneurysm (mRRC3) rate of 9% (95% CI, 0.04–0.20). In addition, recanalization and retreatment rates were reported 10% (95% CI, 0.06–0.17) and 9% (95% CI, 0.06–0.12), respectively. The rates of adverse and serious adverse events were 9% (95% CI, 0.07–0.10) and 6% (95% CI, 0.01–0.22), respectively. Three studies reported a stroke rate which was 2% (95% CI, 0.00–0.13), and five studies reported a mortality rate which was 6% (95% CI, 0.03–0.11). Conclusion The findings suggested that the SMART coil can be a safe and efficient treatment in patients with intracranial aneurysms compared to other available treatment methods.