Evidence map›Paper›PMID 42047837›Full record

SynthesisNeurosurgical review2026

Flow diverting stents for anterior communicating artery aneurysms: A systematic review and meta-analysis of safety, efficacy, and anatomic determinants.

Beste Gülsuna, Parth Patel, Max W Melville, Burak Özaydin, Uttam Verma, Nimer Adeeb, Shyian S Jen, Michael J Feldman, Andrew M Bauer, Hakeem J Shakir

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Beste GülsunaDepartment of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
Parth PatelDepartment of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
Max W MelvilleDepartment of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
Burak ÖzaydinDepartment of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
Uttam VermaDepartment of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
Nimer AdeebDepartment of Neurosurgery, Luisiana State University Health Science Center, New Orleans, LA, USA.
Shyian S JenDepartment of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
Michael J FeldmanDepartment of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
Andrew M BauerDepartment of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
Hakeem J ShakirDepartment of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA. Hakeem-Shakir@ou.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Flow diversion for anterior communicating artery (ACom) aneurysms remains technically challenging due to small vessel caliber, bifurcation anatomy, and perforator involvement. Although case series suggest feasibility, the overall efficacy and safety of flow-diverter (FD) treatment for ACom aneurysms are not well established. Purpose: To synthesize the available evidence on occlusion rates, complications, clinical outcomes, and retreatment following FD treatment for ACom aneurysms. Materials and methods: Following PRISMA guidelines, databases (PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library) were searched for studies published January 2010–September 2025 including ≥ 3 patients treated with FD devices reporting angiographic or clinical outcomes. Extracted data encompassed study characteristics, demographics, aneurysm morphology, treatment details, occlusion, complications, and modified Rankin Scale (mRS). Pooled proportions with 95% confidence intervals (CIs) were calculated via random-effects model in R. Results: Twelve studies (297 patients; 304 ACom aneurysms) were included. Mean age was 64.6 ± 8.4 years; 50.4% were female. Aneurysms were mostly saccular (90.7%), unruptured (76.8%), and small (< 10 mm; mean 4.5 mm). PED was used in 43% of cases; adjunctive coiling in 17.6%. Pooled complete/near-complete occlusion (> 90%) was 78% (95% CI: 66%–86%) at mean 12.5-month follow-up. Pooled complication rate was 21% (95% CI: 13%–31%) and mortality 1% (95% CI: 0%–3%), with permanent morbidity ranged from 5 to 7% across reporting studies. Retreatment was 3.7%; good outcomes (mRS 0–2) 94.7%. Conclusion: FD may offer a technically feasible and potentially effective treatment option for select ACom aneurysms, with pooled data demonstrating 78% near-complete or complete occlusion and 94.7% good functional outcomes at 12.5 month follow-up. However, its role remains investigational, warranting prospective studies to better define long-term safety, durability, and optimal patient selection.

Indexed as

Anterior Cerebral ArteryEndovascular ProceduresIntracranial AneurysmStentsFemaleHumansTreatment OutcomeAneurysmAnterior communicating arteryEndovascular treatmentFlow diversionMicrosurgical clipping

Identifiers

PMID42047837

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.