Neurosurgical review · 2025
Comprehensive assessment of the feasibility, safety, and efficacy of the pressure cooker technique in the treatment of brain arteriovenous malformations: Systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ferreira Marcio Yuri, Barros Emanuel Abrantes, Günkan Ahmet, Scarramal João Paulo L, Cheidde Lidia, de Oliveira Almeida Gustavo, Cardoso Leonardo Januario Campos, de Souza Duarte Matheus, Maia Henrique Garcia, Bertani Raphael, Bocanegra-Becerra Jhon E, Brenner Leonardo B O, Ferreira Christian, Gordon David, Ellis Jason A, Serulle Yafell
Аннотация
PURPOSE: The Pressure Cooker Technique (PCT) is an endovascular technique for brain arteriovenous malformations (bAVMs) that can minimize reflux and inadvertent embolization compared with conventional techniques, leading to a safer and more controlled embolization. This systematic review and meta-analysis aimed to assess the feasibility, safety, and efficacy of PCT for bAVMs.
METHODS: We searched PubMed, Embase, and Web of Science databases. Eligible studies included ≥ 4 patients employing PCT for bAVMs and reporting on clinical and angiographic outcomes. We used single-proportion analysis with 95% confidence intervals under a random-effects model to pool the data. Transvenous (TVE) and transarterial (TAE) approaches were analyzed separately.
RESULTS: Eight observational studies involving 168 patients, 106 treated by TVE and 62 by TAE, were included. The immediate complete obliteration rate was 97% (94%-100%) with TVE and 70% (38%-100%) with TAE. Procedure failure rate was 3% (0%-6%) and 0% (0%-3%) for TVE and TAE, respectively. Intracranial hemorrhagic complications were the most prevalent, with a 13% rate (3%-23%) in TVE. A good clinical outcome rate (Modified Rankin Scale ≤ 2) was 93% (82%-100%) in the TVE. Recurrence was 0% (0%-10%) in the TVE. The surgical retreatment rate was 11% (3%-19%) and 49% (36%-62%) in TVE and TAE, respectively.
CONCLUSION: This systematic review and meta-analysis found that PCT is highly feasible, safe, and effective in treating bAVMs. Given the current evidence, PCT may be considered a valuable option for the treatment of high-grade bAVMs.
METHODS: We searched PubMed, Embase, and Web of Science databases. Eligible studies included ≥ 4 patients employing PCT for bAVMs and reporting on clinical and angiographic outcomes. We used single-proportion analysis with 95% confidence intervals under a random-effects model to pool the data. Transvenous (TVE) and transarterial (TAE) approaches were analyzed separately.
RESULTS: Eight observational studies involving 168 patients, 106 treated by TVE and 62 by TAE, were included. The immediate complete obliteration rate was 97% (94%-100%) with TVE and 70% (38%-100%) with TAE. Procedure failure rate was 3% (0%-6%) and 0% (0%-3%) for TVE and TAE, respectively. Intracranial hemorrhagic complications were the most prevalent, with a 13% rate (3%-23%) in TVE. A good clinical outcome rate (Modified Rankin Scale ≤ 2) was 93% (82%-100%) in the TVE. Recurrence was 0% (0%-10%) in the TVE. The surgical retreatment rate was 11% (3%-19%) and 49% (36%-62%) in TVE and TAE, respectively.
CONCLUSION: This systematic review and meta-analysis found that PCT is highly feasible, safe, and effective in treating bAVMs. Given the current evidence, PCT may be considered a valuable option for the treatment of high-grade bAVMs.