689 Technical Success and Occlusion Rates of eCLIPs Bifurcation Remodeling System for Treatment of Wide-neck Bifurcation Aneurysms: Summary of the Early Experience

Abstract

INTRODUCTION: Wide-necked bifurcation aneurysms (WNBA) are among the most difficult aneurysms to treat. Very low dome-to-neck and aspect ratios provide an even greater challenge in the management of WNBAs. METHODS: A systematic review and meta-analysis was conducted following the PRISMA recommendations. On April 4, 2022, we searched for eligible papers in Pubmed, Web of Science (ISI), Scopus, and Embase databases. The meta-analysis was done using R software version 4.3.0. and the "meta" package. Pooled prevalence (%) and their corresponding 95% confidence intervals (CI), random-effects model based and the generalized linear mixed models (GLMMs) method. On the presence of multiple follow-up points, we included the last available in the analysis. Complete occlusion was defined as Raymond–Roy occlusion classification (RROC) class I, and adequate occlusion was defined as RROC class I or II. RESULTS: Four studies were finally included following the double-reviewer screening of the retrieved literature. The patients' mean age ranged from 56 ± 5.4 to 60±9.2 years, and 82.5% were females. The mean follow-up duration ranged from 8 ± 6.6 months to 28.8 ± 17.6, with all studies giving dual antiplatelet regimens and one added heparinization to their anticoagulation protocol. Technical success was achieved in 88.61% (95% CI = 75.54-95.15) of the cases, while successful adjunctive coiling was obtained in 91.38% (95% CI = 70.71-97.90) of them. The complete occlusion rate was 50.65 (95% CI = 39.63-61.60), while the adequate occlusion rate was 84.42 (95% CI = 74.53-90.93). There was no significant heterogeneity in all pooled outcomes. CONCLUSIONS: The early experience of the device shows an efficacy profile comparable with the currently available devices in treating WNBAs.