Transradial access for the endovascular treatment of intracranial aneurysms using the Woven EndoBridge device: A systematic review and pooled analysis.
Sávio Batista, Filipi Fim Andreão, Raphael Bertani, Leonardo de Barros Oliveira, Dan Zimelewicz Oberman, Lucca B Palavani, Cesar Augusto Ferreira Alves Filho, Fausto de Oliveira Braga, Elias Antônio Tanus Machado, Paulo José da Mata Pereira, Paulo Niemeyer Filho, José Alberto Almeida Filho
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引用次数: 0
Abstract
Background: The Woven EndoBridge (WEB) device is a minimally invasive endovascular treatment option for patients with cerebral aneurysms. Transradial access (TRA) is a technique that involves accessing the arterial system through the radial artery in the wrist rather than the femoral artery in the groin. Several studies have investigated the use of TRA for WEB device deployment in treating intracranial aneurysms.
Methods: A systematic review was conducted to evaluate the TRA for WEB device deployment in treating intracranial aneurysms. The databases PubMed, Cochrane, Embase, Scopus, and Web of Science were searched. To reduce the risk of bias, this systematic review only included studies reporting on using TRA in WEB device deployment for intracranial aneurysm treatment with a minimum of four patients.
Results: In this systematic review, 186 patients were included across five studies, with TRA used in 183 cases analyzed. The study population had a higher proportion of females (n = 118%-69%) than males, with a mean age of 62 years old. Among the aneurysms treated, 46 were ruptured, and 119 were located at bifurcation sites, with a mean maximum diameter/width of 6.6 mm and mean height of 5.9 mm. Adjunctive coiling was used in three cases, and adjunctive stenting was used in nine cases. In two cases, conversion to a femoral artery access was necessary.
Conclusion: The available results suggest TRA with the WEB device is a safe and effective alternative. However, using TRA versus TFA should be individualized based on patient factors and operator experience.
背景：编织内桥（WEB）装置是脑动脉瘤患者的一种微创血管内治疗选择。经桡动脉入路（TRA）是一种通过手腕桡动脉而非腹股沟股动脉进入动脉系统的技术。有几项研究调查了经桡动脉入路技术在治疗颅内动脉瘤的 WEB 装置部署中的应用：方法：我们进行了一项系统性回顾，以评估在治疗颅内动脉瘤时使用 TRA 部署 WEB 装置的情况。检索了 PubMed、Cochrane、Embase、Scopus 和 Web of Science 等数据库。为减少偏倚风险，本系统综述仅纳入了至少有四名患者的关于使用 TRA 部署 WEB 装置治疗颅内动脉瘤的研究：本系统综述共纳入了五项研究中的 186 例患者，其中 183 例分析中使用了 TRA。研究人群中女性比例（n = 118%-69%）高于男性，平均年龄为 62 岁。在接受治疗的动脉瘤中，46个破裂，119个位于分叉部位，平均最大直径/宽度为6.6毫米，平均高度为5.9毫米。有三例使用了辅助卷曲术，九例使用了辅助支架术。有两个病例需要转为股动脉入路：现有结果表明，使用 WEB 设备进行 TRA 是一种安全有效的替代方法。结论：现有结果表明，使用 WEB 设备进行 TRA 是一种安全有效的替代方法。然而，使用 TRA 与 TFA 相比，应根据患者因素和操作者经验进行个体化选择。
期刊介绍：
NRJ - The Neuroradiology Journal (formerly Rivista di Neuroradiologia) is the official journal of the Italian Association of Neuroradiology and of the several Scientific Societies from all over the world. Founded in 1988 as Rivista di Neuroradiologia, of June 2006 evolved in NRJ - The Neuroradiology Journal. It is published bimonthly.
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