title: Flow-diverter devices in the treatment of intracranial aneurysms: A meta-analysis and systematic review.
abstract: OBJECTIVE
  The purpose of this report was to discuss the overall limitations, safety and efficacy of flow-diverter stenting for intracranial aneurysms.
  
  
  METHODS
  The authors performed a meta-analysis from January 2009 to September 2014 using the terms "flow diverter" and "intracranial aneurysms." Additional studies were identified through references in each reviewed article. Data extraction, performed independently by the authors, included demographic data, technical and clinical complications, morbidity and mortality, aneurismal occlusion rates related to flow-diverter devices. The analysis was performed using a fixed effect.
  
  
  RESULTS
  Twenty-nine studies with 1524 patients and three to 62 months of follow-up were identified for analysis. The overall technical failure and complication rate was 9.3% (95% CI 6%-12.6%). The rate of procedure-related complication was 14% (95% CI 10.2%-17.9%) and 6.6% (95% CI 4%-9.1%) for morbidity and mortality. Fusiform, dissecting and circumferential aneurysm (OR 3.10, 95% CI 0.93-10.37) were significant risk factors for technical failure and complication. Posterior circulation location (OR 4.03, 95% CI 2.45-6.61), peripheral location (OR 2.74, 95% CI 1.52-4.94) and fusiform, dissecting and circumferential aneurysm (OR 1.95, 95% CI 1.15-3.30) were statistically significant risk factors for procedure-related complications. Posterior circulation location (OR 4.39, 95% CI 2.44-7.90) and peripheral location (OR 3.64, 95% CI 1.74-7.62) were statistically significant risk factors for morbidity and mortality.
  
  
  CONCLUSIONS
  Fusiform, dissecting and circumferential aneurysm, posterior circulation and peripheral locations have greater procedure-related complications.
authors.affiliation: Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, People's Republic of China.
authors.forename: Xianli
authors.initials: X
authors.lastname: Lv
authors.affiliation: Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, People's Republic of China.
authors.forename: Hongchao
authors.initials: H
authors.lastname: Yang
authors.affiliation: Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, People's Republic of China.
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.affiliation: Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, People's Republic of China lvxianli000@163.com.
authors.forename: Youxiang
authors.initials: Y
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000401:mortality*; D002543:Cerebral Hemorrhage / Q000401:mortality*; D002548:Cerebral Revascularization / Q000401:mortality* / Q000706:statistics & numerical data; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality* / Q000601:surgery*; D020767:Intracranial Thrombosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D015995:Prevalence; D011475:Prosthesis Failure; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: Intracranial aneurysm; endovascular treatment; flow-diverter stenting
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