RT Journal Article
SR Electronic
T1 Braid stability after flow diverter treatment of intracranial aneurysms: a systematic review and meta-analysis
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 298
OP 303
DO 10.1136/jnis-2023-021120
VO 17
IS 3
A1 Ortega-Gutierrez, Santiago
A1 Rodriguez-Calienes, Aaron
A1 Vivanco-Suarez, Juan
A1 Cekirge, H Saruhan
A1 Hanel, Ricardo A
A1 Dibas, Mahmoud
A1 Lamin, Saleh
A1 Rice, Hal
A1 Saatci, Isil
A1 Fiorella, David
A1 Lylyk, Pedro
A1 Baltacioglu, Feyyaz
A1 Lylyk, Ivan
A1 Mendes Pereira, Vitor
A1 Gounis, Matthew J
A1 Fiehler, Jens
YR 2025
UL http://jnis.bmj.com/content/17/3/298.abstract
AB Background The aim of this study was to evaluate the overall rates of braid changes associated with flow diverter (FD) treatment for intracranial aneurysms (IAs). Additionally, we sought to provide an overview of the currently reported definitions related to these complications.Methods A systematic search was conducted from the inception of relevant literature up to April 2023, encompassing six databases. The included studies focused on patients with IAs treated with FDs. We considered four main outcome measures as FD braid changes: (1) fish-mouthing, (2) device braid narrowing, (3) device braid collapsing, and (4) device braid deformation. The data from these studies were pooled using a random-effects model.Results A total of 48 studies involving 3572 patients were included in the analysis. Among them, 14 studies (39%) provided definitions for fish-mouthing. However, none of the included studies offered specific definitions for device braid narrowing, collapsing, or deformation, despite reporting rates for these complications in six, five, and three studies, respectively. The pooled rates for braid changes were as follows: 3% (95% CI 2% to 4%, I2=27%) for fish-mouthing, 7% (95% CI 2% to 20%, I2=85%) for narrowing, 1% (95% CI 0% to 3%, I2=0%) for collapsing, and 1% (95% CI 1% to 4%, I2=0%) for deformation.Conclusion The findings of this study suggest that FD treatment for IAs generally exhibits low rates of fish-mouthing, device braid narrowing, collapsing, and deformation. However, the lack of standardized definitions hinders the ability to compare device outcomes objectively, emphasizing the need for uniform definitions for FD braid changes in future prospective studies on FD.Data are available upon reasonable request.