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Review
. 2024 Jul 25:15910199241264345.
doi: 10.1177/15910199241264345. Online ahead of print.

Comparison of pipeline embolization device and flow redirection endoluminal device in the treatment of intracranial aneurysms: A systematic review and meta-analysis

Basel Musmar  1 , Atakan Orscelik  2 , Hamza Salim  3 , Fares Musmar  4 , Nimer Adeeb  5 , Kareem El Naamani  6 , Muhammed Amir Essibayi  7 , Samantha Spellicy  1 , Jihad Abdelgadir  1 , Adam A Dmytriw  8   9 , Aman B Patel  8 , Vitor Mendes Pereira  9 , Hugo H Cuellar-Saenz  5 , Bharat Guthikonda  5 , Ali Zomorodi  1 , Pascal Jabbour  6 , David Hasan  1
Affiliations
Review

Comparison of pipeline embolization device and flow redirection endoluminal device in the treatment of intracranial aneurysms: A systematic review and meta-analysis

Basel Musmar et al. Interv Neuroradiol. .

Abstract

Background: Advancements in flow diversion technology have revolutionized the treatment of intracranial aneurysms. The pipeline embolization device (PED) and the flow redirection endoluminal device (FRED) have emerged as prominent tools in this field. This study aims to compare the safety and efficacy profiles of PED and FRED in the treatment of intracranial aneurysms.

Methods: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across PubMed, Web of Science, and Scopus databases. Studies comparing PED and FRED were included and data extraction focused on study characteristics, patient demographics, and clinical and radiological outcomes. Primary outcomes were favorable outcomes, described as modified Rankin scale (mRS) 0-2 score, and complete/near-complete occlusion, while secondary outcomes included retreatment rate and thromboembolic and hemorrhagic complications.

Results: Five studies, comprising 1238 patients, were included. No significant differences were found between PED and FRED in terms of complete occlusion at 6 months and 1 year, complete/near-complete occlusion at the last follow up, retreatment rates, and thromboembolic, in-stent thrombosis and hemorrhagic complications. However, FRED was significantly associated with higher favorable outcomes compared to PED (odds ratio: 0.37; confidence interval: 0.17 to 0.81; p = 0.01).

Conclusion: This study showed that both PED and FRED had comparable rates of complete occlusion, retreatment and complications, and FRED also demonstrated a higher likelihood of achieving favorable outcomes. The study underscores the need for further research with larger cohorts and longer follow up to consolidate these findings.

Keywords: Aneurysms; flow redirection endoluminal device; intracranial; meta-analysis; pipeline embolization device.

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Conflict of interest statement

Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA diagram.
Figure 2.
Figure 2.
Forest plot for favorable outcome.
Figure 3.
Figure 3.
Forest plot for aneurysmal occlusion rates.
Figure 4.
Figure 4.
Forest plot for retreatment rates and follow up.
Figure 5.
Figure 5.
Forest plot for periprocedural complications (thromboembolic, hemorrhagic, in-stent thrombosis, total complications).
See this image and copyright information in PMC

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