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中华神经创伤外科电子杂志

中华神经创伤外科电子杂志 ›› 2019, Vol. 05 ›› Issue (02) : 73 -78. doi: 10.3877/cma.j.issn.2095-9141.2019.02.003

所属专题： 文献；

临床研究

可膨胀水凝胶弹簧线圈与裸铂弹簧线圈栓塞颅内动脉瘤有效性及安全性的Meta分析
王俊杰1, 范琴2, 曹西1, 刘震洋2, 李宏倬3,†()   
  1. 1. 046000　长治，长治医学院研究生院
    2. 030000　太原，山西大医院神经外科
    3. 046000　长治，长治医学院附属和平医院骨科
  • 收稿日期:2018-11-26 出版日期:2019-04-15
  • 通信作者: 李宏倬

Hydrogel coils vs bare platinum coils in the treatment of intracranial aneurysms: a Meta analysis

Junjie Wang1, Qin Fan2, Xi Cao1, Zhenyang Liu2, Hongzhuo Li3,†()   

  1. 1. Graduate School of Changzhi Medical College, Changzhi 046000, China
    2. Department of Neurosurgery, Shanxi Dayi Hospital, Taiyuan 030000, China
    3. Department of Orthopaedics, Heping Affiliated Hospital of Changzhi Medical College, Changzhi 046000, China
  • Received:2018-11-26 Published:2019-04-15
  • Corresponding author: Hongzhuo Li
  • About author:
    Corresponding author: Li Hongzhuo, Email:
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王俊杰, 范琴, 曹西, 刘震洋, 李宏倬. 可膨胀水凝胶弹簧线圈与裸铂弹簧线圈栓塞颅内动脉瘤有效性及安全性的Meta分析[J]. 中华神经创伤外科电子杂志, 2019, 05(02): 73-78.

Junjie Wang, Qin Fan, Xi Cao, Zhenyang Liu, Hongzhuo Li. Hydrogel coils vs bare platinum coils in the treatment of intracranial aneurysms: a Meta analysis[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2019, 05(02): 73-78.

目的

比较可膨胀水凝胶弹簧线圈与裸铂弹簧线圈治疗颅内动脉瘤的有效性及安全性。

方法

系统检索Pubmed、Embase、Web of Science、Cochrane图书馆、中国知网及万方数据库自建库至2018年11月收录的关于使用水凝胶弹簧圈及裸铂弹簧圈治疗颅内动脉瘤的文献。制定文献的纳入与排除标准，筛选符合纳入标准的文献。采用RevMan5.3软件进行Meta分析。

结果

共纳入4篇文献，均为英文文献，样本量为1526例。Meta分析的结果表明，水凝胶线圈和裸铂线圈在术中完全栓塞动脉瘤（OR=0.89，95%CI：0.67~1.17，P=0.39）、术后18个月患者恢复情况（OR=1.35，95%CI：0.99~1.84，P=0.06）、所有并发症发生比例（OR=0.87，95%CI：0.69~1.10，P=0.25）方面差异均并无统计学意义，异质性较小（I2<50%，P>0.05）。

结论

同传统裸铂弹簧线圈相比，水凝胶弹簧线圈的有效性及安全性基本相同。

关键词: 水凝胶弹簧线圈, 裸铂弹簧线圈, 颅内动脉瘤, Meta分析
Objective

To compare the efficacy and safety of hydrogel coils and bare platinum coils in the treatment of intracranial aneurysms by a Meta analysis.

Methods

Systematic retrieval of literature on the use of hydrogel coils and bare platinum coils in the treatment of intracranial aneurysms from the Pubmed, Embase, Web of Science, Cochrane Library, CNKI and Wanfang data from initiation of the databases to November 2018. The included studies were screened out strictly based on the criterion of inclusinon and exclusion. Revman 5.3 was used for Meta analysis.

Results

A total of 4 literature were included, all in English, with a sample of 1526 cases. The results of Meta analysis showed that there was no significant difference between hydrogel coil and bare platinum coil in embolization of aneurysms (OR=0.89, 95%CI: 0.67-1.17, P=0.39), recovery of patients 18 months after operation (OR=1.35, 95%CI: 0.99-1.84, P=0.06), and incidence of all complications (OR=0.87, 95%CI: 0.69-1.10, P=0.25), and with a relatively low heterogeneity (I2<50%, P>0.05).

Conclusion

Compared with bare platinum coils, hydrogel coils have similar efficacy and safety in in the treatment of intracranial aneurysms.

Key words: Hydrogel coils, Bare platinum coils, Intracranial aneurysms, Meta analysis
图1 文献筛选流程图
图2 纳入文献的质量评价情况
表1 纳入文献基本特征
作者 发表年份 例数 年龄 性别（男/女） 破裂/未破裂动脉瘤
水凝胶组 裸铂组 水凝胶组 裸铂组 水凝胶组 裸铂组 水凝胶组 裸铂组
White等[5] 2011 249 250 51.0 51.0 73/176 76/174 139/110 138/112
Raymond等[6] 2014 225 222 57.0±11.0 58.0±12.0 60/165 65/157 40/185 39/183
Poncyljusz等[7] 2015 50 46 49.6±10.8 52.2±8.7 19/31 16/30 0/50 0/46
Taschner等[8] 2016 243 241 52.9±12.6 54.1±11.8 71/172 80/161 103/140 105/136
图3 线圈栓塞颅内动脉瘤的术后效果森林图
图4 线圈栓塞颅内动脉瘤术后18个月的影像学及恢复情况森林图
图5 线圈栓塞颅内动脉瘤术后并发症发生情况森林图
图6 残余动脉瘤瘤颈敏感性分析森林图
[1]
Molyneux A, Kerr R, Stratton I, et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial[J]. Lancet, 2002, 360(9342): 1267-1274.
[2]
Raymond J, Molyneux AJ, Fox AJ, et al. The TEAM trial: safety and efficacy of endovascular treatment of unruptured intracranial aneurysms in the prevention of aneurysmal hemorrhages: a randomized comparison with indefinite deferral of treatment in 2002 patients followed for 10 years[J]. Trials, 2008, 9: 43.
[3]
Darsaut TE, Fahed R, Macdonald RL, et al. Surgical or endovascular management of ruptured intracranial aneurysms: an agreement study[J]. J Neurosurg, 2018, Epub ahead of print.
[4]
Kallmes DF, Fujiwara NH. New expandable hydrogel-platinum coil hybrid device for aneurysm embolization[J]. AJNR Am J Neuroradiol, 2002, 23(9): 1580-1588.
[5]
White PM, Lewis SC, Gholkar A, et al. Hydrogel-coated coils versus bare platinum coils for the endovascular treatment of intracranial aneurysms (HELPS): a randomised controlled trial[J]. Lancet, 2011, 377(9778): 1655-1662.
[6]
Raymond J, Klink R, Chagnon M, et al. Patients prone to recurrence after endovascular treatment: periprocedural results of the PRET randomized trial on large and recurrent aneurysms[J]. AJNR Am J Neuroradiol, 2014, 35(9): 1667-1676.
[7]
Poncyljusz W, Zarzycki A, Zwarzany Ł, et al. Bare platinum coils vs. HydroCoil in the treatment of unruptured intracranial aneurysms-A single center randomized controlled study[J]. Eur J Radiol, 2015, 84(2): 261-265.
[8]
Taschner CA, Chapot R, Costalat V, et al. GREAT-a randomized controlled trial comparing HydroSoft/HydroFrame and bare platinum coils for endovascular aneurysm treatment: procedural safety and core-lab-assessedangiographic results[J]. Neuroradiology, 2016, 58(8): 777-786.
[9]
Brisman JL, Song JK, Newell DW. Cerebral aneurysms[J]. N Engl J Med, 2006, 355(9): 928-939.
[10]
UCAS Japan Investigators, Morita A, Kirino T, et al. The natural course of unruptured cerebral aneurysms in a Japanese cohort[J]. N Engl J Med, 2012, 366(26): 2474-2482.
[11]
Wiebers DO, Whisnant JP, Huston J, et al. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment[J]. Lancet, 2003, 362(9378): 103-110.
[12]
Taschner CA, Thines L, El-Mahdy M, et al. GDC 360 degrees for the endovascular treatment of intracranial aneurysms: a matched-pair study analysing angiographic outcomes with GDC 3D Coils in 38 patients[J]. Neuroradiology, 2009, 51(1): 45-52.
[13]
Plowman RS, Clarke A, Clarke M, et al. Sixteen-year single-surgeon experience with coil embolization for ruptured intracranial aneurysms: recurrence rates and incidence of late rebleeding[J]. J Neurosurg, 2011, 114(3): 863-874.
[14]
Naggara ON, White PM, Guilbert F, et al. Endovascular treatment of intracranial unruptured aneurysms: systematic review and meta-analysis of the literature on safety and efficacy[J]. Radiology, 2010, 256(3): 887-897.
[15]
Satoh K, Matsubara S, Hondoh H, et al. Intracranial aneurysm embolization using interlocking detachable coils. Correlation between volume embolization rate and coil compaction[J]. Interv Neuroradiol, 1997, 3 Suppl 2: 125-128.
[16]
Tamatani S, Ito Y, Koike T, et al. Evaluation of the stability of intracranial aneurysms occluded with guglielmi detachable coils[J]. Interv Neuroradiol, 2001, 7(Suppl 1): 143-148.
[17]
Turner RD, da Costa LB, terBrugge KG. A multicenter registry of hydrocephalus following coil embolization of unruptured aneurysms: which patients are at risk and why it occurs[J]. J Neurointerv Surg, 2013, 5(3): 207-211.
[18]
Marchan EM, Sekula RF Jr, Ku A, et al. Hydrogel coil-related delayed hydrocephalus in patients with unruptured aneurysms[J]. J Neurosurg, 2008, 109(2): 186-190.
[19]
White PM, Raymond J. Endovascular coiling of cerebral aneurysms using "bioactive" or coated-coil technologies: a systematic review of the literature[J]. AJNR Am J Neuroradiol, 2009, 30(2): 219-226.
[20]
Broeders JA, Ahmed Ali U, Molyneux AJ, et al. Bioactive versus bare platinum coils for the endovascular treatment of intracranial aneurysms: systematic review and meta-analysis of randomized clinical trials[J]. J Neurointerv Surg, 2016, 8(9): 898-908.
[21]
Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test[J]. BMJ, 1997, 315(7109): 629-634.
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