Abstract
Objective To analyze the effect and safety of treating intracranial dissecting aneurysm (IDA) by deconstruction and reconstruction in China. Methods We searched the literatures about interventional treatment of IDA in Pubmed and Wanfang medical ranging from January 2008 to December 2017 and withdrew the data from abstracts in literature. Comparing the effectiveness and safety of deconstruction and reconstruction in treating IDA by using RevMan 5.3, this study counted events consisting of postoperative recurrence, death related to IDA, and other perioperative complications. Results A total of 18 articles reported 1 102 cases of IDA including 269 cases with deconstruction and 833 cases with reconstruction. In the deconstruction group, there were 8 (2.97%) cases of recurrence, 5 (1.86%) deaths, 15 (5.58%) cases of other perioperative complications. In the reconstruction group, there were 98 (11.76%) cases of recurrence, 10 (1.20%) cases of death and 16 (1.92%) cases of other perioperative complications, which were summed up to a total of 124 (14.89%) cases. In the fixed effect model, comparison between the 2 groups in dissection recurrence (OR=0.36, 95%CI: 0.20-0.64, I2=12%, P=0.0005) indicated that the risk of recurrence in deconstruction group was lower than that in the reconstruction group. In addition, comparison of the complications except recurrence (OR=2.35, 95%CI: 1.27-4.23, I2=4%, P=0.0006) showed that the risks of mortality, disability and other complications were lower in deconstruction group. Comparing all complications (OR=0.69, 95%CI: 0.45-1.05, I2=37%, P=0.0800) suggested that deconstruction was better than reconstruction in treating IDA. Conclusion The effect and safety of deconstruction might be better than those of reconstruction in treating IDA. With the development of materials, the effect of reconstruction would be expected to improve. Key words: Aneurysm, dissecting; Meta-analysis; Embolization, therapeutic; Stents; Treatment outcome
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