SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
This article is part of the Research TopicInnovation Application and Outcomes in Flow Diverter Interventions for Complex Intracranial AneurysmsView all 6 articles
Efficacy and Safety of Flow Diverters in Small Intracranial Aneurysms: A Systematic Review and Single-Arm Meta-analysis
Provisionally accepted
Kuerban Maimaitiaili1
Maimaitiaili Nuermaimaiti1Adili Rouzi1Aisan Seyiti1Mairidan Yasheng1Xiong Guo1Moming Abulaiti1Ying Xiao1Hongbo Pan1Ainipai Sidike2Yanbing Hu1*Dawutijiang Yilamu1*- 1The Second People’s Hospital of Kashgar Region, Kashgar, China
- 2Kashgar No. 8 Middle School, Kashgar, China
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Objective: This study aimed to evaluate the efficacy and safety of flow diverters (FDs) in the treatment of small intracranial aneurysms (≤10 mm). Methods: PubMed, Embase, Web of Science, and Cochrane Library were comprehensively searched up to July 2025. Eligible studies included retrospective cohort studies reporting angiographic and clinical outcomes of FD treatment in small intracranial aneurysms. Data analysis was conducted using STATA 15.0. Pooled proportions and 95% confidence intervals (CIs) were calculated using Freeman–Tukey double arcsine transformation. Publication bias was evaluated using funnel plots and Egger’s test. Results: Ten retrospective studies comprising 2,275 patients with 1,938 aneurysms were included. The pooled complete or near-complete occlusion rate was 86% (95% CI: 80%–92%). The treatment-related mortality rate was 1% (95% CI: 0%–2%), and the hemorrhagic event rate was 1% (95% CI: 1%–2%). The ischemic event rate was 2% (95% CI: 1%–3%), and the stroke rate was 3% (95% CI: 1%–5%). The overall complication rate was 9% (95% CI: 5%–12%), while 98% (95% CI: 94%–100%) of patients achieved favorable functional outcomes. Egger’s test showed no significant publication bias (P=0.791). Conclusion: FDs appear to be both effective and safe for the treatment of small intracranial aneurysms, achieving high occlusion rates and favorable functional outcomes with low rates of mortality and complications. However, given the high heterogeneity and retrospective nature of the included studies, further large-scale prospective studies are warranted to confirm these findings and refine treatment strategies.
Keywords: Flow diverters, small intracranial aneurysms, IntracranialAneurysms, fds, Meta-analysis
Received: 16 Sep 2025; Accepted: 07 Nov 2025.
Copyright: © 2025 Maimaitiaili, Nuermaimaiti, Rouzi, Seyiti, Yasheng, Guo, Abulaiti, Xiao, Pan, Sidike, Hu and Yilamu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yanbing Hu, 1428319488@qq.com
Dawutijiang Yilamu, kedawutjan@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.