Efficacy And Safety Of Pipeline Embolization Devices With Shield Technology For Intracranial Aneurysms: A Meta-analysis

Objective(s): When an intracranial aneurysm ruptures,blood flows directly into the subarachnoid space,causing subarachnoid hemorrhage,which is associated with a high rate of disability and mortality.The pipeline embolization device(PED)is a common endovascular treatment for intracranial aneurysms,especially for large,giant,wide-necked,or dissecting aneurysms.The addition of a layer of phosphorylcholine biocompatible polymer to the surface of the PED can significantly improve its performance.The PED with this shield technology(Pipeline Shield)is a relatively new innovation,and its early technical success and safety have been reported.In this study,we conducted a systematic literature review to evaluate the efficacy and safety of the Pipeline Shield.Methods: We conducted a comprehensive search of several databases,including Pub Med,Embase,Cochrane Library,Wanfang database,Weipu database,and CNKI,in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Results: We selected five prospective and two retrospective studies for review.A total of 572 aneurysms were included;of these,506(88.5%)were unruptured.The antiplatelet regimens were heterogeneous.The rate of perioperative and postoperative complications was 11.1% [95% confidence interval(CI): 6.5–18.9%].The aneurysm occlusion rate at 6 months was 73.9%(95% CI: 69.1–78.7%).The aneurysm occlusion rate of more than 12 months was 80.9%(95% CI: 75.1–86.1%).The mortality rate was 0.7%(95% CI: 0.2–1.5%).Conclusion(s): This study suggests that Pipeline Shield exhibits good effectiveness in the treatment of intracranial aneurysms,and does not increase patient mortality rate,making it a relatively safe treatment option.