title: Flow-Diverting Devices versus Coil Embolization for Intracranial Aneurysms: A Systematic Literature Review and Meta-analysis.
abstract: OBJECTIVE
  To review the literature on flow-diverting device (FDD) treatments for intracranial aneurysms (IAs) and to compare the safety and efficacy of FDDs with coil embolization treatment (CET) for IAs using a meta-analysis of published studies.
  
  
  METHODS
  A systematic electronic search was conducted of PubMed, Springer Link, EBSCO, and the Cochrane Database on all accessible published articles through September 2015. Abstracts, full-text manuscripts, and the reference lists of retrieved articles were analyzed. Studies that explicitly compared FDD and CET approaches to the treatment of IAs were included. Odds ratios (ORs) and 95% CIs were calculated for the complete occlusion rate and the morbidity rate using a random-effects model.
  
  
  RESULTS
  Nine studies were included in the analysis, containing retrospectively collected data for 863 patients. FDD treatment showed a significantly higher complete occlusion rate than CET (OR = 3.13; 95% confidence interval [CI], 2.11-4.65) and the subgroup of stent-assisted coiling did (OR = 2.08; 95% CI, 1.34-3.24). FDDs did not achieve a significantly lower overall morbidity rate compared with CET (OR = 0.87; 95% CI, 0.45-1.69) or the SAC (stent-assisted coiling) subgroup (OR = 0.86; 95% CI, 0.33-2.26), and our results did not show a significant difference in mortality between the two techniques.
  
  
  CONCLUSIONS
  FDD treatment of IAs yielded satisfactory results in complete occlusion rate compared with CET. The FDD procedure is feasible and has no significant difference in morbidity risk. Despite the findings reported herein, further validation with well-designed, multicenter randomized controlled trials is needed.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Geng
authors.initials: G
authors.lastname: Zhou
authors.affiliation: Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Yue-Qi
authors.initials: YQ
authors.lastname: Zhu
authors.affiliation: Shandong Academy Of Chinese Medicine, Lixia, Jinan, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Su
authors.affiliation: School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
authors.forename: Kai-Di
authors.initials: KD
authors.lastname: Gao
authors.affiliation: Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. Electronic address: liminghua12@163.com.
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Li
mesh_terms: D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000401:mortality*; D057510:Endovascular Procedures / Q000295:instrumentation / Q000401:mortality*; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D015995:Prevalence; D018570:Risk Assessment; D015607:Stents / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Cerebral aneurysm; Coiling; Endovascular; Flow diverting device; Stent