Endovascular treatment of very small (3 mm or smaller) XXXX : report of a consecutive series and a meta-analysis.

@entity1 @entity510 @entity1756 @entity439 @entity1031 @entity397 @entity438
BACKGROUND AND PURPOSE: We performed a meta-analysis of published studies on the endovascular treatment of very small @entity438 , including 71 @entity1 treated at our institution. METHODS: We conducted a computerized MEDLINE search of the literature for reports on the treatment of @entity438 with a maximum dimension of </=3 mm by using the search terms "small," "tiny," " @entity438 ," "endovascular," and "coil." A total of 7 studies, including our institution's consecutive case series of 71 @entity438 , were included in this study. We extracted information regarding intraoperative complications, procedural mortality and morbidity, immediate- and long-term angiographic outcomes, and retreatment rate. The meta-analysis was performed with the statistical package Comprehensive Meta-Analysis. RESULTS: Approximately 61% of the @entity439 in this meta-analysis presented as ruptured, whereas 39% of the @entity439 were unruptured. Procedural @entity397 rates for very small @entity439 was 8.3% (95% CI, 6.0% to 11.4%). The mortality rate due to procedural @entity397 was 2.4% (95% CI, 1.2% to 4.7%). The morbidity rate due to @entity1031 complications was 1.9% (95% CI, 0.9% to 3.9%). @entity510 within 1 month of treatment occurred in 1.6% (95% CI, 0.6% to 3.7%) of cases. There was no statistically significant difference between unruptured and @entity1756 for any of these outcomes. CONCLUSIONS: Our meta-analysis suggests that treatment of very small @entity439 is feasible and effective in >90% of treated @entity439 . However, the risk of periprocedural @entity397 is higher than that reported for larger @entity439 . Similarly, the combined rate of periprocedural mortality and morbidity is not negligible (7.3%) and should be considered when considering the best therapeutic option for these @entity439 .
