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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurointervention

Treatment of Middle Cerebral Artery Aneurysms with Flow-Diverter Stents: A Systematic Review and Meta-Analysis

F. Cagnazzo, D. Mantilla, P.-H. Lefevre, C. Dargazanli, G. Gascou and V. Costalat
American Journal of Neuroradiology December 2017, 38 (12) 2289-2294; DOI: https://doi.org/10.3174/ajnr.A5388
F. Cagnazzo
aFrom the Neuroradiology Department, University Hospital Güi-de-Chauliac, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
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D. Mantilla
aFrom the Neuroradiology Department, University Hospital Güi-de-Chauliac, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
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P.-H. Lefevre
aFrom the Neuroradiology Department, University Hospital Güi-de-Chauliac, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
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C. Dargazanli
aFrom the Neuroradiology Department, University Hospital Güi-de-Chauliac, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
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G. Gascou
aFrom the Neuroradiology Department, University Hospital Güi-de-Chauliac, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
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V. Costalat
aFrom the Neuroradiology Department, University Hospital Güi-de-Chauliac, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
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Article Figures & Data

Tables

  • Angiographic outcomes and treatment-related complications

    VariablesRaw NumbersaNo. of Articles95% CII2P Value
    MCA aneurysm occlusion after flow diversion
        Overall rate of complete/near-complete occlusion137/171 = 78.7%1067.8–89.776.24<.001
    Factors related to aneurysm occlusion
        Mean age (yr).262
            Complete/near-complete occlusion53.6 yr447.3–59.875%
            Incomplete occlusion61.3 yr48.9–73.595%
    Mean size.614
        Complete/near-complete occlusion7 mm63.6–10.383.6%
        Incomplete occlusion5.5 mm0.8–10.199%
    Complete/near-complete occlusion.38
        Retreatment64%533.9–93.475.2%
            vsvs
            First treatment73%63–83.50%
    Complete/near-complete occlusion.307
        Prebifurcation (M1–early cortical branches)88.1%1179.6–96.70%
            vsvs
            Bifurcation aneurysms77.7%64.5–89.574.92%
    Complications related to treatment and outcome
        Overall rate of treatment-related complications46/213 = 20.7%1114–27.534.03%.126
        Transient or asymptomatic11.3%7.6–16.2
            vsvs116.8–15.2
            Permanent10.3%
        Type of complications
            Ischemic/thromboembolic16.3%1110.1–22.636.65%.106
            Hemorrhagic2%0.2–3.90%.958
            Iatrogenic (dissection/perforation)1.8%0%–1.3.5%0%.973
            Perianeurysmal inflammation2.6%0.5–4.70%.997
        Complications related to discontinuation of antiplatelet therapy4/46 = 8.7%112.9–20.8
        Aneurysm rupture after treatment1/214 = 0.47%120.1–2.8
        Overall rate of good outcome125/135 = 92.7%786.4–99.142.08%.11
        Mortality rate4/213 = 2%110.2–3.9%0%.929
    • Note:— vs indicates versus.

    • ↵a Results of meta-analysis.

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American Journal of Neuroradiology: 38 (12)
American Journal of Neuroradiology
Vol. 38, Issue 12
1 Dec 2017
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F. Cagnazzo, D. Mantilla, P.-H. Lefevre, C. Dargazanli, G. Gascou, V. Costalat
Treatment of Middle Cerebral Artery Aneurysms with Flow-Diverter Stents: A Systematic Review and Meta-Analysis
American Journal of Neuroradiology Dec 2017, 38 (12) 2289-2294; DOI: 10.3174/ajnr.A5388

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Treatment of Middle Cerebral Artery Aneurysms with Flow-Diverter Stents: A Systematic Review and Meta-Analysis
F. Cagnazzo, D. Mantilla, P.-H. Lefevre, C. Dargazanli, G. Gascou, V. Costalat
American Journal of Neuroradiology Dec 2017, 38 (12) 2289-2294; DOI: 10.3174/ajnr.A5388
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  • Two year follow-up of distal unruptured intracranial aneurysms treated with a surface modified flow diverter under prasugrel monotherapy
  • Active drug-coated flow diverter in a preclinical model of intracranial stenting
  • Magnetic resonance perfusion imaging findings following flow diversion in patients with complex middle cerebral artery bifurcation aneurysms: a single-center analysis regarding the jailed cortical branches
  • Surgical or Endovascular Treatment of MCA Aneurysms: An Agreement Study
  • Multi-centric European post-market follow-up study of the Neuroform Atlas Stent System: primary results
  • Distal anterior cerebral artery aneurysms treated with flow diversion: experience of a large-volume center and systematic review of the literature
  • Flow modification on the internal carotid artery bifurcation region and A1 segment after M1-internal carotid artery flow diverter deployment
  • Advances in endovascular aneurysm management: flow modulation techniques with braided mesh devices
  • Flow-Diversion Treatment for Unruptured Nonsaccular Intracranial Aneurysms of the Posterior and Distal Anterior Circulation: A Meta-Analysis
  • Flow diversion covering the M1 origin as a last resort
  • Stent assisted coiling versus non-stent assisted coiling for the management of ruptured intracranial aneurysms: a meta-analysis and systematic review
  • On Flow Diversion: The Changing Landscape of Intracerebral Aneurysm Management
  • Treatment of Unruptured Distal Anterior Circulation Aneurysms with Flow-Diverter Stents: A Meta-Analysis
  • Flow-Diversion Treatment of Unruptured Saccular Anterior Communicating Artery Aneurysms: A Systematic Review and Meta-Analysis
  • Y-Stent-Assisted Coiling of Wide-Neck Bifurcation Intracranial Aneurysms: A Meta-Analysis
  • Treatment of Intracranial Aneurysms with Self-Expandable Braided Stents: A Systematic Review and Meta-Analysis
  • Flow-Diversion Effect of LEO Stents: Aneurysm Occlusion and Flow Remodeling of Covered Side Branches and Perforators
  • PED Flex with Shield Technology: a feasible alternative for fusiform MCA aneurysms
  • Treatment of Distal Anterior Cerebral Artery Aneurysms with Flow-Diverter Stents: A Single-Center Experience
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