SynthesisNeurosurgical review2024
Comparative efficacy and safety of N-butyl cyanoacrylate vs. Onyx in the treatment of arteriovenous malformations: a systematic review and meta-analysis.
Synthesis in Neurosurgical review, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Since the first use of embolization for cerebral arteriovenous malformations (AVMs) by Luessenhop and Spence in 1960, this procedure has become a cornerstone in the multimodal treatment approach for brain AVMs. Currently, in the United States, the main embolic agents employed are n-butyl cyanoacrylate (NBCA) and Onyx (Medtronic, Minneapolis, MN). This systematic review and meta-analysis aim to compare these two agents in terms of efficacy and safety. An updated guideline for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. The search strategy involved retrieving articles from PubMed, Scopus, and Web of Science from inception of these databases until June 27th, 2024, using specific search terms. Inclusion criteria were comparative studies of Onyx (Medtronic, Minneapolis, MN) and NBCA, peer-reviewed original studies published in full-text, and studies reporting at least one of the outcomes of interest. Statistical analysis was performed using R software version 4.3.1. After screening 3177 articles, 33 articles were assessed in full-text, and 4 studies were included in the final analysis. These studies included 374 patients, 170 (45.4%) females. There was no significant difference in complication rates between Onyx (Medtronic, Minneapolis, MN) and NBCA (risk ratio [RR]: 0.91; CI: 0.31 to 2.67, p = 0.86) with significant heterogeneity (I²=68%, p = 0.02). Technical success did not differ significantly (RR: 1.38; CI: 0.72 to 2.62, p = 0.33) with significant heterogeneity (I²=73%, p = 0.02). Mortality (RR: 1.5; CI: 0.28 to 8.08, p = 0.64; I²=16%, p = 0.31), morbidity (RR: 1.39; CI: 0.16 to 12.08, p = 0.76; I²=53%, p = 0.14), and blood loss (MD: -0.1; CI: -0.8 to 0.5, p = 0.72; I²=53%, p = 0.15) also showed no significant differences. Both NBCA and Onyx are effective and safe for embolization of cerebral AVMs, with no significant differences in complications, technical success, mortality, morbidity, and blood loss. Further research, particularly randomized controlled trials, is needed to better understand their comparative efficacy and safety.
Indexed as
Identifiers
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Registered trials
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 OpenQuestion graph.