Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 21:13:1101625.
doi: 10.3389/fneur.2022.1101625. eCollection 2022.

Willis covered stent treatment for blood blister-like aneurysm: A meta-analysis of efficacy and safety

Jiahe Tan  1 , Rui Song  2 , Siyue Luo  3 , Wenqiao Fu  1 , Jun Su  1 , Zhaohui He  1
Affiliations

Willis covered stent treatment for blood blister-like aneurysm: A meta-analysis of efficacy and safety

Jiahe Tan et al. Front Neurol. .

Abstract

Background: Blood blister-like aneurysm (BBA) is a rare and special type of intracranial aneurysm with extremely high rates of rupture, morbidity, mortality, and recurrence. Willis Covered Stent (WCS) is a new device that is specifically designed for the treatment of intracranial complex aneurysms. However, the efficacy and safety of WCS treatment for BBA remain controversial. Thus, a high level of evidence is required to prove the efficacy and safety of WCS treatment.

Methods: A systematic literature review was performed using a comprehensive literary search in Medline, Embase, and Web of Science databases to identify studies related to WCS treatment for BBA. A meta-analysis was then conducted to incorporate the efficacy and safety outcomes, including intraoperative situation, post-operative situation, and follow-up data.

Results: Eight non-comparative studies containing 104 patients with 106 BBAs met the inclusion criteria. In the intraoperative situation, the technical success rate was 99.5% [95% confidence interval (CI), 0.958, 1.000], the complete occlusion rate was 98.2% (95% CI, 0.925, 1.000), and the side branch occlusion rate was 4.1% (95% CI, 0.001, 0.114). Vasospasm and dissection occurred in 9.2% (95% CI, 0.000, 0.261) and 0.1% (95% CI, 0.000, 0.032) of the patients, respectively. In the post-operative situation, the rebleed and mortality rates were 2.2% (95% CI, 0.000, 0.074) and 1.5% (95% CI, 0.000, 0.062), respectively. In the follow-up data, recurrence and parent artery stenosis occurred in 0.3% (95% CI, 0.000, 0.042) and 9.1% (95% CI, 0.032, 0.168) of the patients, respectively. Ultimately, 95.7% (95% CI, 0.889, 0.997) of the patients had a good outcome.

Conclusions: Willis Covered Stent could be effectively and safely applied for BBA treatment. The results provide a reference for clinical trials in the future. Well-designed prospective cohort studies must be conducted for verification.

Keywords: blood blister-like aneurysm; covered stent; efficacy; meta-analysis; safety.

PubMed Disclaimer

Conflict of interest statement

The reviewer [OC] declared a shared affiliation with the authors to the handling editor at the time of review. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A flowchart of the literature search performed.
Figure 2
Figure 2
Forest plots of the intraoperative outcome rate. (A) Technical success, (B) complete occlusion, (C) side branch occlusion, (D) vasospasm, and (E) dissection.
Figure 3
Figure 3
Forest plots of the post-operative outcome rate. (A) Rebleed and (B) mortality.
Figure 4
Figure 4
Forest plots of the follow-up outcome rate. (A) Recurrence, (B) parent artery stenosis, and (C) good outcome.
See this image and copyright information in PMC

References

    1. Sim SY, Shin YS, Cho KG, Kim SY, Kim SH, Ahn YH, et al. Blood blister-like aneurysms at nonbranching sites of the internal carotid artery. J Neurosurg. (2006) 105:400–5. 10.3171/jns.2006.105.3.400 - DOI - PubMed
    1. Ji T, Guo Y, Huang X, Xu B, Xu K, Yu J. Current status of the treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery: a review. Int J Med Sci. (2017) 14:390–402. 10.7150/ijms.17979 - DOI - PMC - PubMed
    1. Zhai X-D, Hu P, He C, Feng Y-S, Li G-L, Zhang H-Q. Current knowledge of and perspectives about the pathogenesis of blood blister-like aneurysms of the internal carotid artery: a review of the literature. Int J Med Sci. (2021) 18:2017–22. 10.7150/ijms.53154 - DOI - PMC - PubMed
    1. Shah SS, Gersey ZC, Nuh M, Ghonim HT, Elhammady MS, Peterson EC. Microsurgical versus endovascular interventions for blood-blister aneurysms of the internal carotid artery: systematic review of literature and meta-analysis on safety and efficacy. J Neurosurg. (2017) 127:1361–73. 10.3171/2016.9.JNS161526 - DOI - PubMed
    1. Tang C, Qi S. Efficacy and safety of willis covered stent for treatment of internal carotid artery aneurysms. J Craniofac Surg. (2017) 28:e263–5. 10.1097/SCS.0000000000003565 - DOI - PubMed

Publication types