SynthesisNeurosurgical review2025
Evolving strategies in the management of vertebral artery dissecting aneurysms involving the posterior inferior cerebellar artery: a systematic review and meta-analysis.
Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVertebral artery dissecting aneurysms (VADAs) involving the posterior inferior cerebellar artery (PICA) origin present a unique therapeutic challenge due to high rupture risk, complex anatomy, and the critical need to preserve brainstem perfusion. Despite the increasing use of endovascular strategies, no prior meta-analysis has specifically evaluated outcomes for this clinically high-risk subgroup.
objectiveTo systematically review and quantitatively synthesize available data on the endovascular management of VADAs involving the PICA origin.
methodsA comprehensive literature search of PubMed and Scopus was conducted per PRISMA guidelines. Studies reporting clinical outcomes for VADAs involving the PICA origin treated with endovascular techniques were included. Pooled estimates were calculated for key outcomes using a random-effects meta-analysis model. Heterogeneity and publication bias were assessed.
resultsThis review included 141 patients. The majority (90.1%) presented with ruptured aneurysms. In the literature, stent-assisted coiling (SAC) was the most frequently employed reconstructive strategy, with a 12.5% recurrence rate (95% CI: 6-24%) and a 20% rebleeding rate (95% CI: 12-38%, p < 0.001) according to one-arm proportional meta-analysis. The overall complete occlusion following endovascular therapy was 49.2% (95% CI: 94-100%). PICA patency was preserved in 43.7% of cases. The overall ischemic complication rate was 15.6%, and mortality was 6.4%, predominantly in patients undergoing deconstructive treatments. Most patients achieved favorable neurological outcomes (mRS ≤ 2).
conclusionsFlow diversion appears to be a promising option for PICA-involving VADAs, demonstrating comparable early occlusion rates with no reported re-bleeding in the limited cases available, and a lower tendency to recur compared with SAC. SAC retains value in anatomically favorable, nondominant lesions, though its higher rebleeding risk limits its use when branch hemodynamics are complex. Larger, prospective multicenter studies are needed to refine flow-diverter protocols and define the specific circumstances in which adjunctive or stent-assisted techniques remain advantageous. CLINICAL TRIAL: Not applicable.
Indexed as
Identifiers
40591052What OpenQuestion holds
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.