Meta Analysis Of Factors Related To Recurrence After Endovascular Embolization Treatment Of Middle Cerebral Artery Aneurysms

Objective:To investigate the factors related to recurrence after endovascular embolization treatment of middle cerebral artery aneurysms.Methods:Following the principle of evidence-based medicine and the procedure of Cochrane system evaluation, takeing the computer retrieval method and manual retrieval method to search MEDLINE, EMBASE, Cochrane Library, CNKI from 2000 to Dec.2010. Collecting the retrospective etiology analysis researches related to recurrent factors after endovascular embolization treatment of middle cerebral. The quality of included trials was evaluated by two estimators. And meta-analysis was conducted on homogeneous studies.Results:(1) Eight studies were included.There are 613 middle cerebral artery aneurysms (MCAAs)included,and 144 MCAAs occurred recurrences during the follow-up. (2) All included studies complied with the standard of Lichtenstein. (3) The conclusion of Meta-analysis as follow:(1) The OR(95%CI) of ruptured MCAAs and unruptured MCAAs was 1.7(1,08 -2.67).The difference had significance statistically, p value<0.05.(Ⅱ) The OR(95%CI) of the initally completely occluded MCAAs and uncompletely occludedd MCAAs was 0.18 (0.11,0.29).The difference had significance statistically, p value<0.05. (Ⅲ) The OR(95%CI) of the small MCAAs (sac size<7mm)and large MCAAs (sac size≥7mm) was 0.55 (0.35,0.82).The difference had significance statistically, p value<0.05. (IV) The OR(95%CI) of the narrow-neck MCAAs (aneurysm neck size≤4mm)and the wide-neck MCAAs (aneurysm neck size>4mm) was 0.47 (0.26,0.85). The difference had significance statistically, p value< 0.05.Conclusions:(1) The ruptured MCAAs easily lead to recurrence after endovascular embolization treatment compared with unruptured MCAAs(2) Compared with initally uncompletely occluded MCAAs. the inilally completely occluded MCAAs can reduced recurrence effective after endovaseular embolization treatment.(3) The large MCAAs (sac size≥7mm) easily lead to recurrence after endovascular emboliza- tion treatment compared with the small MCAAs(sac size<7mm).(4) Although the technology of endovascular embolization treatment of wide-neck aneurysms has been improved a lot, the narrow-neck MCAAs (aneurysm neck size≤4mm) still easily lead to recurrence after endovascular embolization treatment compared with the wide-neck MCAAs (aneurysm neck size>4mm).