OBJECTIVE To conduct meta-regression for the identification of clinically meaningful characteristics that can predict successful treatment of intracranial aneurysms(IAs)with the Pipeline Embolization Device(PED).METHO...OBJECTIVE To conduct meta-regression for the identification of clinically meaningful characteristics that can predict successful treatment of intracranial aneurysms(IAs)with the Pipeline Embolization Device(PED).METHODS Using the keyword"Pipeline Embolization Device"and pre-specified eligibility criteria,we searched PubM ed and EMBASE and identified 105 original research articles(10,813 patients)published or in press(April 6,2011-December 31,2016)focused on safety and/or effectiveness of PED.We constructed meta-regression models to identify predictors of three measures of PED treatment success,specifically rates of aneurysm occlusion,modified Rankin score(mRS)and death.Rates were loge-transformed and the adjusted R2 statistic was reported for each model.RESULTS Aneurysm morphology and type accounted for substantial variation in 1-year aneurysm occlusion rate(14 studies with 689 patients;Radj2=88.91%).By contrast,predictors of 6-months aneurysm occlusion rate(aneurysm location,aneurysm type)(24 studies with 1,321 patients;Radj2=31.67%)and aneurysm occlusion rate at unspecified follow-up time(year of publication,mean duration of angiographic follow-up)(34 studies with 1,663 patients,Radj2=42.82%)accounted for less variability.Few predictors were identified for death rate(number of patients,aneurysm morphology;34 studies with 6,463 patients,Radj2=50.69%)or mRS≤2(year of publication,mean age,aneurysm morphology;14 studies with 556 patients,Radj2=100%).CONCLUSIONS:Few clinically meaningful characteristics appear to be relevant as predictors of the selected measures of PED treatment success.Future studies should attempt to identify additional predictors while focusing on aneurysm morphology as a key predictor of PED outcomes.展开更多
文摘OBJECTIVE To conduct meta-regression for the identification of clinically meaningful characteristics that can predict successful treatment of intracranial aneurysms(IAs)with the Pipeline Embolization Device(PED).METHODS Using the keyword"Pipeline Embolization Device"and pre-specified eligibility criteria,we searched PubM ed and EMBASE and identified 105 original research articles(10,813 patients)published or in press(April 6,2011-December 31,2016)focused on safety and/or effectiveness of PED.We constructed meta-regression models to identify predictors of three measures of PED treatment success,specifically rates of aneurysm occlusion,modified Rankin score(mRS)and death.Rates were loge-transformed and the adjusted R2 statistic was reported for each model.RESULTS Aneurysm morphology and type accounted for substantial variation in 1-year aneurysm occlusion rate(14 studies with 689 patients;Radj2=88.91%).By contrast,predictors of 6-months aneurysm occlusion rate(aneurysm location,aneurysm type)(24 studies with 1,321 patients;Radj2=31.67%)and aneurysm occlusion rate at unspecified follow-up time(year of publication,mean duration of angiographic follow-up)(34 studies with 1,663 patients,Radj2=42.82%)accounted for less variability.Few predictors were identified for death rate(number of patients,aneurysm morphology;34 studies with 6,463 patients,Radj2=50.69%)or mRS≤2(year of publication,mean age,aneurysm morphology;14 studies with 556 patients,Radj2=100%).CONCLUSIONS:Few clinically meaningful characteristics appear to be relevant as predictors of the selected measures of PED treatment success.Future studies should attempt to identify additional predictors while focusing on aneurysm morphology as a key predictor of PED outcomes.
