Efficacy and Safety of P48 Flow Diverters in the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis Publisher



B Hajikarimloo BARDIA ; I Mohammadzadeh IBRAHIM ; Sm Tos Salem M ; Ma Habibi Mohammad AMIN ; R Hashemi RANA ; A Hasanzade ARMAN ; A Ebrahimi AZIN ; K Didehvar KIMIA ; M Hooshmand MAHDI ; Sh Bana Sarah H
Source: Neuroradiology Published:2025

Abstract

Background: The p48 movable wire (MW) flow modulation devices are a group of novel low-profile flow diverters (FDs) that have recently been introduced for the management of small intracranial aneurysms (IAs). This study evaluates the current literature regarding the efficacy and safety of p48 in treating IAs. Methods: A literature search was conducted using the PubMed, Embase, Scopus, and Web of Science databases. Studies evaluating the role of p48 FDs in IAs were included. Results: Twelve studies encompassing 312 individuals with 330 IAs were included. The meta-analysis revealed a pooled complete occlusion rate of 58% (95% CI: 40%-75%), a favorable outcome rate of 96% (95% CI: 86%-100%), and a morbidity rate of 1% (95% CI: 0%-3%). Regarding the complications, our findings showed a pooled intraprocedural rate of 7% (95% CI: 1%-16%), a postprocedural rate of 9% (95% CI: 6%-13%), an ischemic complication rate of 8% (95% CI: 5%-12%), a hemorrhagic complication rate of 3% (95% CI: 1%-5%), and an in-stent stenosis rate of 1% (95% CI: 0%-3%). The subgroup analysis comparing p48 MW and p48 MW with a hydrophilic coating (HPC) did not demonstrate significant differences between groups in outcomes and complications, except for hemorrhagic complications, which were higher in p48 MW than in p48 MW HPC devices (p48: 3% vs. p48 HPC: 0%, P = 0.04). Conclusion: The p48 FDs represent novel therapeutic options in the management of IAs, associated with promising outcomes and low complication rates. © 2025 Elsevier B.V., All rights reserved.