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Commentary about a 20th meta-analysis
  1. Emmanuel Houdart
  1. Service de Neuroradiologie, Hôpital Lariboisière, Paris, France
  1. Correspondence to Dr Emmanuel Houdart, Hospital Lariboisière, 75475 Paris, Île-de-France, France; emmanuel.houdart{at}

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I read with interest the article "How safe and effective are flow diverters for the treatment of unruptured small/medium intracranial aneurysms of the internal carotid artery? Meta-analysis for evidence-based performance goals" published in September 2020.1

I anticipated, in a letter on the symptomatic abundance of meta-analyses on flow diversion (FD), 19 in 7 years, that awaiting rigorous evaluation, ‘we can bet that we will still have the opportunity to read a new meta-analysis in the near future’.2 I thank the authors for proving me right.

The authors of this 20th meta-analysis report that the morbidity/mortality of FD of small unruptured carotid aneurysms (<10 mm in most patients) in uncontrolled case series was 7.8% (4.8%–11.4%). The abstract concludes: 'this treatment is associated with low rates of morbidity and …

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  • Contributors I have no conflict of interest.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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