PT  - JOURNAL ARTICLE
AU  - Habtezghi, Abiel Berhe
AU  - Ghozy, Sherief
AU  - Bilgin, Cem
AU  - Kobeissi, Hassan
AU  - Kadirvel, Ramanathan
AU  - Kallmes, David F.
TI  - DWI-Detected Ischemic Lesions after Endovascular Treatment for Cerebral Aneurysms: An Updated Systematic Review and Meta-analysis
AID  - 10.3174/ajnr.A8024
DP  - 2023 Oct 12
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2023/10/12/ajnr.A8024.short
4100  - http://www.ajnr.org/content/early/2023/10/12/ajnr.A8024.full
AB  - BACKGROUND AND PURPOSE: DWI-detected ischemic lesions are potential complications of endovascular procedures that are performed to treat intracranial aneurysms. We completed a systematic review and meta-analysis to identify the occurrence of DWI-detected ischemic lesions after endovascular treatment for intracranial aneurysms.MATERIALS AND METHODS: A systematic literature search of PubMed, the Web of Science, EMBASE, and Scopus between January 2000 and June 2022 of post-endovascular procedures for intracranial aneurysm studies was conducted using the Nested Knowledge AutoLit software. The main outcome was DWI-detected ischemic lesions within 5 days of the procedures. Information regarding associated risk factors such as the type of procedure, patient demographics, and aneurysm characteristics was also collected.RESULTS: Twenty-nine studies with 2686 patients were included. The overall incidence of DWI ischemic lesions was 47.0% (95% CI, 39.6%–55.8%). The highest rate of lesions was seen with flow diversion at 62.4% (95% CI, 48.4%–80.5%), followed by complex procedures at 49.3% (95% CI, 29.5%–82.1%), stent-assisted coiling at 47.5% (95% CI, 34.6%–65.3%), simple coiling at 47.1% (95% CI, 35.7%–62.3%), and balloon-assisted coiling at 37.0% (95% CI, 28.3%–48.4%). The differences among different techniques were not statistically significant; however, there was significant heterogeneity and a significant risk of publication bias among included studies.CONCLUSIONS: Many patients who undergo endovascular procedures for intracranial aneurysms present with new postprocedural DWI-detected ischemic lesions, regardless of the endovascular procedure used. Future studies and meta-analyses are needed to investigate early and long-term outcomes of such small infarcts.APCannual percentage change