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Meta Analysis of Factors Related to Recurrence after Endovascular Embolization Treatment of Middle Cerebral Artery Aneurysms

Author: HuChu
Tutor: WangHongQin
School: Shanxi Medical
Course: Neurosurgery
Keywords: Brain aneurysm Interventional embolization Recurrence System Evaluation Retrospective etiology analysis
CLC: R651.12
Type: Master's thesis
Year: 2011
Downloads: 36
Quote: 0
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Abstract


Objective: To investigate the cerebral artery aneurysm (middle cerebral artery aneurysms, MCAAs) embolization of recurrence . Method : follow the principles of evidence-based medicine , in accordance with the steps of the Cochrane systematic review , using the method of combining computer searches and manual searches of the literature database search from January 2000 to December 2010 , MEDLINE , EMBASE, the Cochrane Library , CNKI , included in the retrospective etiology analysis of the relevant brain aneurysm embolization of factors associated with recurrence after surgery , and then by two evaluators jointly evaluating the quality of the included studies . Finally, the study met the inclusion criteria Meta-analysis was performed using Rev Man 4.2 software . Results: (1) meet the requirements included in the eight retrospective etiology analysis of brain aneurysm , a total of 613 cases of recurrence during follow-up brain aneurysm is a total of 144 cases . ( 2 ) are included in the study , all meet the the Lichtenstein of case-control studies evaluation criteria . (3) Meta analysis showed that : (1) preoperative to rupture MCAAs and preoperative of unruptured MCAAs relapse rate advantage than OR (odds ratio, OR) values ??(95% CI) 1.7 ( 1.08,2.67 ) and the difference was statistically significance (P lt; 0.05). The difference was statistically significant ( P lt; 0.05 ) (Ⅱ) initial complete to embolism MCAAs and the initial incomplete embolization MCAAs recurrence rate odds ratio OR value (95% CI) 0.18 ( 0.11,0.29 ) . (Ⅲ) tumor diameter lt ; a 7mm of MCAAs and tumor diameter ≥ a 7mm of MCAAs recurrence rate odds ratio OR value (95% CI) 0.55 ( 0.35,0.82 ) difference was statistically significant ( P lt; 0.05 ) . ( IV ) neck ≤ a 4mm of MCAAs and neck gt ; of 4mm of MCAAs relapse rate advantage than the OR value (95% CI) 0.47 ( 0.26,0.85 ) and the difference was statistically significant ( P lt; 0.05 ) . Conclusion: ( 1) broken MCAAs than unruptured MCAAs more easily in interventional embolization recurrence . ( 2) compared to the initial incomplete embolization after initial complete occlusion , MCAAs more effective in reducing the recurrence rate . (3) tumor diameter ≥ the 7mm 's MCAAs than the tumor diameter lt ; the 7mm 's MCAAs history easily lead to recurrence after embolization . (4 ) Although the interventional treatment of wide-necked aneurysms technology has been greatly improved , but the neck gt; the 4mm of MCAAs still neck ≤ 4 mm of MCAAs more likely to lead to recurrence after embolization .

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CLC: > Medicine, health > Surgery > Of surgery > Head and Neurosurgery > Brain > Cerebrovascular surgery
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