Flow-diverting device versus coil embolization for unruptured intracranial aneurysm: A meta-analysis

Optimizing Patient Care: A Multicentric Study on the Clinical Impact of Sim&Size™ Simulation Software in Intracranial Aneurysm Treatment With Pipeline Embolization Devices

BACKGROUND

To determine the clinical effects (stent size, and number of stents used) of the Sim&Size™ simulation software on the endovascular treatment of unruptured saccular intracranial aneurysms with Pipeline Embolization Devices (PED).

METHODS

This study is a retrospective analytical multicenter study of patients treated with PED (Flex and Flex with SHIELD) for intracranial aneurysm in FOSCAL clinic and CHU de Montpellier.

RESULTS

The study included 253 patients, of which 75 were treated in Colombia and 178 were treated in France. The majority of patients were women (83.8%), with a median age of 57.48 years, and had large vessel location (88.1%), with most aneurysms located in the ICA paraclinoid segment (56.8%). Patients in the group with Sim&Size™ simulation had shorter stents than those without simulation (15.62 mm versus 17.36 mm, P-value = 0.001). Also, a lower proportion of these patients required more than one stent (1.4% versus 7.3%, P-value = 0.022). There were 7 complications reported in the group that used the Sim&Size™ simulation software, compared to 9 complications in the group that did not use the software.

CONCLUSIONS

Using Sim&Size™ simulation software for endovascular treatment of patients with intracranial aneurysms using PED reduces the stent length and decreasing the number of devices needed per treatment.

A novel flow diverter device (Tubridge) for the treatment of intracranial aneurysms: a systematic review and meta-analysis

The flow diverter (FD) device has become a feasible and effective option for treating intracranial aneurysms. This study aimed to evaluate the efficacy and safety of Tubridge FD (TFD) in treating intracranial aneurysms and provide evidence for further research and clinical application. Electronic databases, including PubMed, Web of Science, Embase, and the Cochrane Library from inception to July 31, 2022, were searched. The eligible studies should include TFD investigations in treating intracranial aneurysms. Pooled technical success rate, complete occlusion rate, improvement rate, stable rate, symptom elimination rate, and adverse events rate were calculated with either the fixed-effects model or the random-effects model, depending on the results of tests for heterogeneity. Egger's tests were performed to assess the potential publication bias. A total of 7 studies (145 patients) were included in this study. The pooled technical success rate was 0.98, the complete occlusion rate was 0.79, the improvement rate was 0.21, and the stable rate was 0.05. One included study reported that the surgery-related mortality rate in the Tubridge group was higher than that in the control group (3.66% vs. 1.61%), while the surgery-related morbidity rate in the Tubridge group was 2.4% and that in the control group was 0. Findings of this meta-analysis indicate that TFD manifests promising and effective performance with acceptable adverse events in the treatment of intracranial aneurysms.

Analysis of Clinical Effects of Comprehensive Nursing Based on Enhanced Recovery after Surgery in Patients with Embolization for Intracranial Aneurysms

Objective. This research sets out to elucidate the clinical effect of comprehensive nursing based on the concept of enhanced recovery after surgery (ERAS) in patients with embolization for intracranial aneurysms (IAs). Methods. This study enrolled 119 patients with embolization for IAs in the Zhongnan Hospital of Wuhan University from January 2020 to January 2021 and divided them into two groups according to the perioperative care they received: a control group ( $n=39$ ) treated with routine perioperative nursing and an observation group ( $n=80$ ) treated with ERAS-based comprehensive nursing. Surgical indicators, neurological function (National Institute of Health Stroke Scale (NIHSS) score; Scandinavian Stroke Scale (SSS) score), anxiety and depression (Self-Rating Anxiety Scale (SAS) score; Self-Rating Depression Scale (SDS) score), incidence of adverse events, and patient satisfaction were compared. Results. The observation group had better surgical indicators and lower scores of NIHSS, SSS, SAS, and SDS than the control group, accompanied by a lower incidence of adverse events and higher patient satisfaction. Conclusions. ERAS-based comprehensive nursing can better promote patients’ neurological recovery after embolization for IAs, relieve unhealthy emotions (depression, anxiety, etc.), and reduce the occurrence of adverse reactions, facilitating patient discharge.