Evidence map›Paper›PMID 41563595›Full record

SynthesisNeurosurgical review2026

Comparative outcomes of surpass streamline and evolve flow diverters in intracranial aneurysms: a comprehensive systematic review and meta-analysis of location, size, and morphology.

Farhang Rashidi, Mohammad Amin Habibi, Mohammadmahdi Sabahi, Mohammad Reza Arshadi, Mohammad Sina Mirjnani, Parisa Javadnia, Parastoo Radnia, Mohammad Mofatteh, Mohammad Sadegh Mashayekhi, Ehsan Dowlati and 5 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Full text at PMC 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. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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

15 authors.

Farhang RashidiDepartment of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Amin HabibiDepartment of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
Mohammadmahdi SabahiDepartment of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA.
Mohammad Reza ArshadiDepartment of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Sina MirjnaniDepartment of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
Parisa JavadniaDepartment of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
Parastoo RadniaDepartment of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad MofattehSchool of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Mohammad Sadegh MashayekhiDivision of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
Ehsan DowlatiDepartment of Neurosurgery, North Shore University Hospital, Manhasset, NY, USA.
Farhan SiddiqDepartment of Neurological Surgery, University of Missouri School of Medicine, Columbia, MO, USA.
Mubashir PervezDepartment of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA.
Kunal VakhariaDepartment of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
Andrew BauerDepartment of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Michal ObrzutDepartment of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA. obrzutm@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The Surpass flow diverter, including Streamline and Evolve, features a unique design optimized for improved conformability, opening, and wall apposition. Its unique pore structure allows for deployment across a wide range of arterial diameters, contributing to its high occlusion rates. The current study aims to compare the efficacy and safety of the Surpass Streamline and Evolve in treating intracranial aneurysms, with a focus on location, size, and morphology. A systematic review and meta-analysis was carried out according to the PRISMA guidelines, utilizing PubMed, Web of Science, Scopus, and Embase, from inception to August 1st, 2024. Relevant data were extracted, and data synthesis was performed using STATA v.17. The analysis included 27 studies with 1,826 patients (76.7% female; ages 28-84 years) and 2,006 intracranial aneurysms (1,743 anterior, 222 posterior; 28 blister, 20 dissecting, 116 fusiform, and 1,597 saccular). The pooled complete occlusion rate at the final follow-up was 77%, with no significant differences between anterior (80%) and posterior (64%) circulation aneurysms (P = 0.15) or small (70%) and large/giant (79%) aneurysms (P = 0.36). Morphological analysis revealed that blister, dissecting, saccular, and fusiform aneurysms had 100%, 65%, 55%, and 79% complete occlusion rates, respectively (P < 0.001). Surpass Streamline had 81% complete occlusion success versus 69% for Evolve (P = 0.04). The overall adequate occlusion rate was 90%, with Streamline at 92% and Evolve at 88% (P = 0.35). Higher occlusion rates were observed in posterior aneurysms (100% vs. 92%; P < 0.001). Large/giant aneurysms had a higher rate of adequate occlusion (100% vs. 88%; P = 0.12). Morphological analysis showed that blister and dissecting aneurysms had 100% adequate occlusion, fusiform aneurysms had 75% adequate occlusion, and saccular aneurysms had 96% adequate occlusion (P = 0.04). Mortality, complications and in-stent thrombosis were significantly reduced with Evolve (P = 0.03, 0.001 and 0.000, respectively). Our study indicates the efficacy and safety of the Surpass flow diverter for treating intracranial aneurysms, offering a satisfactory occlusion rate. The surpass Evolve was associated with a lower incidence of major complications.

Indexed as

Endovascular ProceduresIntracranial AneurysmStentsAdultAgedHumansMiddle AgedTreatment OutcomeAneurysmEvolveFlow diverterStreamlineSurpass

Identifiers

PMID41563595
PMCPMC12823732

What OpenQuestion holds

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Registered trials

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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.