Evidence map›Paper›PMID 36508085›Full record

SynthesisPituitary2023

Vascular anomalies in patients with growth hormone-secreting pituitary adenomas: illustrative case report and systematic review of the literature.

Dorothee Cäcilia Spille, Elena Vorona, Michael P Catalino, Gilles Reuter, Albert Beckers, Markus Holling, Arianna Fava, Walter Stummer, Edward R Laws, Eric Suero-Molina

Open access · hybridAbstract readSystematic ReviewCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Pituitary, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 17% of its field
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. 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

10 authors at 6 institutions in 4 countries.

Dorothee Cäcilia SpilleDepartment of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, A1, 48149, Münster, Germany.
Elena VoronaDepartment of Medicine B of Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology Division for Endocrinology and Diabetes, 48149, Münster, Germany.
Michael P CatalinoThe University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
Gilles ReuterDepartment of Neurosurgery, University Hospital of Liège, Liège, Belgium.
Albert BeckersCentre Hospitalier Universitaire de Liège, Liège, Belgium.
Markus HollingDepartment of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, A1, 48149, Münster, Germany.
Arianna FavaDepartment of Neurosurgery, I.R.C.C.S. Neuromed, Pozzilli, IS, Italy.
Walter StummerDepartment of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, A1, 48149, Münster, Germany.
Edward R LawsDepartment of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA.
Eric Suero-MolinaDepartment of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, A1, 48149, Münster, Germany. e.suero@uni-muenster.de.
University Hospital Münster · DEBrigham and Women's Hospital · USCentre Hospitalier Universitaire de Liège · BEIstituto Neurologico Mediterraneo · ITThe University of Texas MD Anderson Cancer Center · USUniversity of Liège · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEndonasal resection is the first-line treatment for patients harboring growth hormone (GH)-secreting pituitary adenomas. The complexity of the parasellar neurovascular structures makes pre-operative diagnostic imaging essential to understanding the anatomy of this region. We aimed to describe vascular anomalies in acromegalic patients and emphasize their relevance for surgery and preoperative planning.

methodsA systematic review following the PRISMA statement was performed in July 2021.

resultsThirty-three studies were evaluated. Elevated GH and insulin-like growth factor-1 (IGF-1) levels are linked to the occurrence of cardiovascular risk factors. This is attributed to endothelial dysfunction, mainly caused by changes in flow-mediated dilatation (FMD), which is probably the main cause of vascular anomalies in acromegaly. The occurrence of protrusions of the internal carotid artery (ICA) (35-53%), a narrow intercarotid distance, and an asymmetrical course was described. In 13-18% of acromegalic patients, the presence of an intracerebral aneurysm could be reported (incidence in the general population:0.8-1.3%). The selected studies were however performed with a small patient sample (range:1-257). We present a case report of a 57y/o male patient with anomalies of the ICA ("kissing carotid arteries") harboring a GH-secreting adenoma, which was resected via an endoscopic endonasal approach.

conclusionsThere is an association between acromegaly and endothelial dysfunction, which increases cardiovascular risk factors and vascular anomalies. Preoperative vascular imaging, e.g., CT angiography, should be implemented as a standard to identify patients at risk and estimate surgical morbidity. However, no evidence-based recommendations exist so far, so future studies are necessary.

Indexed as

AcromegalyAdenomaGrowth Hormone-Secreting Pituitary AdenomaHuman Growth HormonePituitary NeoplasmsHumansMaleMiddle AgedHuman Growth HormoneAcromegalyAdenomaEndothelial dysfunctionGrowth hormonePituitary

Identifiers

PMID36508085
PMCPMC9908726
OpenAlexW4311201466

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.