The incidence of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by microsurgical clipping versus endovascular coiling: a systematic review

Chinese Journal of Contemporary Neurology and Neurosurgery

Jian-wei GAO¹  Yun-li WU¹  Long WANG¹  Zhi-bin SONG¹  Xu-guang LI¹  Bing GUO¹  Qing-guo LIU¹ 

[1] Department of Neurosurgery, Peace Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Shanxi, China;

关键词: Hydrocephalus;    Intracranial aneurysms;    Embolization, therapeutic;    Microsurgery;    Meta-analysis;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objective To systematically review the risk ofshunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysmsby microsurgical clipping versus endovascular coiling. Methods A comprehensive literature search from January 1990 toSeptember 2015 was conducted in electronic databases, such as PubMed,EMBASE/SCOPUS, Cochrane Central Register of Controlled Trials (CENTRAL), ChinaNational Knowledge Infrastructure (CNKI) and Wanfang data, for randomizedcontrolled trials (RCTs) or observational studies. Key words were defined ashydrocephalus, shunt, clipping, coiling, surgical, endovascular, embolization,treatment, intracranial aneurysm, cerebral aneurysm, subarachnoid hemorrhageboth in Chinese and English. Manual search was also conducted on severalrelevant journals, such as Chinese Journal of Neurosurgery, Chinese Journal ofContemporary Neurology and Neurosurgery, Chinese Journal of CerebrovascularDiseases, and so on. Data were extracted and evaluated by two reviewersindependently. Jadad Scale was used to assess the quality of RCTs.Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of nonrandomizedcontrolled trials. RevMan 5.3 and Stata 13.1 were used for Meta-analysis. Results Eighteen observational studies were finally included,involving 15 920 patients with ruptured intracranial aneurysms, among whom 10038 patients underwent clipping and 5882 underwent coiling. The result ofMeta-analysis indicated that there was no statistical significance on theincidence of shunt-dependent hydrocephalus between clipping and coiling(OR = 0.860, 95%CI: 0.720-1.030; P = 0.110). However, thefindings showed low stability as the results of fixed effects model and randomeffects model were different. The result of Egger's test indicated nopublication bias (P = 0.795).  Conclusions Thefrequency of shunt-dependent hydrocephalus was not significantly differentbetween clipping and coiling. However, the conclusion still needs to be furtherverified by high-quality studies.

 

DOI: 10.3969/j.issn.1672-6731.2016.02.003

【 授权许可】

Unknown