Endovascular Treatment of Very Large and Giant Intracranial Aneurysms: Comparison between Reconstructive and Deconstructive Techniques—A Meta-Analysis

F. Cagnazzo; D. Mantilla; A. Rouchaud; W. Brinjikji; P.-H. Lefevre; C. Dargazanli; G. Gascou; C. Riquelme; P. Perrini; D. di Carlo; A. Bonafe; V. Costalat

doi:10.3174/ajnr.A5591

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Table 1:

Angiographic outcomes for unruptured and ruptured very large/giant intracranial aneurysms—comparison between reconstructive and deconstructive treatments

Variables	Unruptured Group (Results of Meta-Analysis)	No. of Articles	P Value	Ruptured Group (Results of Meta-Analysis)	No. of Articles	P Value
Angiographic outcomes
Long-term aneurysm occlusion (complete/near-complete)	122/175 = 71%	14		23/31 = 72%	5
Reconstructive	(60–81) (I² = 69%)			(57–87) (I² = 0%)
vs			.003^{^a}			.5
Deconstructive	147/158 = 93%			13/15 = 80%	4
Deconstructive	(89–98) (I² = 4%)	8		(60–97) (I² = 42%)
Recanalization after reconstructive treatment	45/110 = 40%	9		15/31 = 47%	4
Recanalization after reconstructive treatment	(13–60) (I² = 95%)			(30–64) (I² = 0%)
vs			.001^{^a}			.1
Recanalization after deconstructive treatment	3/66 = 5%			1/8 = 22%
Recanalization after deconstructive treatment	(1–10) (I² = 0%)	6		(7–52) (I² = 49%)	3
Time between treatment and recanalization
Reconstructive	Median, 5 mo; mean, 8.7 mo; IQR, 4–13.5
vs	vs
Deconstructive	Median 6 mo; mean 13 mo; IQR, 5–21
Retreatment after reconstructive treatment	34/105 = 32%	8		14/29 = 48%	3
Retreatment after reconstructive treatment	(10–55) (I² = 90%)			(30–66) (I² = 0%)
vs			.001^{^a}			.007^{^a}
Retreatment after deconstructive treatment	1/66 = 4%			1/8 = 22%
Retreatment after deconstructive treatment	(1–8) (I² = 0%)	6		(7–52) (I² = 49%)	3
Early aneurysm rupture after reconstructive treatment	8/165 = 5%	14		3/37 = 8%	6
vs	(1.7–8) (I² = 0%)		.08	(2–22) (I² = 5%)		.2
Early aneurysm rupture after deconstructive treatment	0/86	8		0/36	5
Late aneurysm rupture after reconstructive treatment	3/148 = 3%	12		0/36	5
vs	(0.6–6.2) (I² = 0%)		.4			.4
Late aneurysm rupture after deconstructive treatment	0/86	8		0/10	4