Journal of neurointerventional surgery · 2026
Endovascular treatment for Moyamoya-associated intracranial aneurysms: a 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.
de Bastos Maximiano Mariana Letícia, Ribeiro Gonçalves Ocílio, Magalhães Pedro Lucas Machado, Ohannesian Victor Arthur, Falcão Luciano, Arruda Gabriel, Donato Kenzo Ogasawara, da Silva Anderson Matheus Pereira, Virgilio Ribeiro Filipe, Valverde Maria Eduarda Scheffer, Santos Diogo Haddad, Günkan Ahmet, Jabbour Pascal
Аннотация
BACKGROUND: Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive stenosis of the distal internal carotid arteries, leading to increased collateral flow and the development of an abnormal vascular network, which imposes shear stress on small vessels and increases the risk of aneurysm formation. Endovascular treatment (EVT) has emerged as a potential approach for managing MMD-associated intracranial aneurysms (MMD-IA), but its safety and efficacy remain unclear.
OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the safety, efficacy, and long-term outcomes of EVT in patients with MMD-IA.
METHODS: A comprehensive search was conducted across PubMed, Embase, and Web of Science, adhering to PRISMA guidelines. Studies reporting clinical and angiographic outcomes for EVT of MMD-IA were included. The primary outcomes were complete aneurysm occlusion, functional outcomes, procedural complications, and recurrence rates. Pooled analyses with 95% confidence intervals (95% CIs) were conducted, with heterogeneity assessed using I² statistics, and a random-effects model was applied.
RESULTS: Seventeen studies, comprising 506 patients (36.33% female; mean age: 49.24±10.91 years) with aneurysms were included. Of these, 181 patients underwent EVT. The pooled complete occlusion rate was 86.46% (95% CI: 39.28 to 98.44) immediately after embolization and 84.51% (95% CI: 75.67 to 90.54) at last follow-up. Procedure-related complications were 15.27% (95% CI: 9.88 to 22.85) and the prevalence of subarachnoid hemorrhage after the procedure was 5.25% (95% CI: 2.20 to 12.05). The prevalence of ischemic procedural complications was estimated at 8.69% (95% CI: 4.49 to 16.16). Functional independence (modified Rankin Scale (mRS) 0-2) was achieved in 86.93% (95% CI: 73.55 to 94.09) of cases at follow-up. The aneurysm recurrence rate was 8.08% (95% CI: 3.05 to 19.69), emphasizing the need for long-term monitoring.
CONCLUSIONS: EVT appears to be a safe and effective treatment for MMD-IA, demonstrating high occlusion rates and favorable functional outcomes. However, the risk of aneurysm recurrence highlights the importance of long-term follow-up. Further large studies are necessary to confirm these findings and optimize treatment strategies for this complex condition.
OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the safety, efficacy, and long-term outcomes of EVT in patients with MMD-IA.
METHODS: A comprehensive search was conducted across PubMed, Embase, and Web of Science, adhering to PRISMA guidelines. Studies reporting clinical and angiographic outcomes for EVT of MMD-IA were included. The primary outcomes were complete aneurysm occlusion, functional outcomes, procedural complications, and recurrence rates. Pooled analyses with 95% confidence intervals (95% CIs) were conducted, with heterogeneity assessed using I² statistics, and a random-effects model was applied.
RESULTS: Seventeen studies, comprising 506 patients (36.33% female; mean age: 49.24±10.91 years) with aneurysms were included. Of these, 181 patients underwent EVT. The pooled complete occlusion rate was 86.46% (95% CI: 39.28 to 98.44) immediately after embolization and 84.51% (95% CI: 75.67 to 90.54) at last follow-up. Procedure-related complications were 15.27% (95% CI: 9.88 to 22.85) and the prevalence of subarachnoid hemorrhage after the procedure was 5.25% (95% CI: 2.20 to 12.05). The prevalence of ischemic procedural complications was estimated at 8.69% (95% CI: 4.49 to 16.16). Functional independence (modified Rankin Scale (mRS) 0-2) was achieved in 86.93% (95% CI: 73.55 to 94.09) of cases at follow-up. The aneurysm recurrence rate was 8.08% (95% CI: 3.05 to 19.69), emphasizing the need for long-term monitoring.
CONCLUSIONS: EVT appears to be a safe and effective treatment for MMD-IA, demonstrating high occlusion rates and favorable functional outcomes. However, the risk of aneurysm recurrence highlights the importance of long-term follow-up. Further large studies are necessary to confirm these findings and optimize treatment strategies for this complex condition.