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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurointervention

Deconstructive and Reconstructive Techniques in Treatment of Vertebrobasilar Dissecting Aneurysms: A Systematic Review and Meta-Analysis

Ö. Sönmez, W. Brinjikji, M.H. Murad and G. Lanzino
American Journal of Neuroradiology July 2015, 36 (7) 1293-1298; DOI: https://doi.org/10.3174/ajnr.A4360
Ö. Sönmez
aFrom the Departments of Neurosurgery (Ö.S., G.L.)
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W. Brinjikji
bRadiology (W.B.)
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M.H. Murad
cCenter for Science of Healthcare Delivery (M.H.M.), Mayo Clinic, Rochester, Minnesota.
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G. Lanzino
aFrom the Departments of Neurosurgery (Ö.S., G.L.)
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Article Figures & Data

Tables

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    Table 1:

    Summary of studies

    Author, YearNo. of PatientsNo. RupturedNo. UnrupturedReconstructive TechniquesDeconstructive TechniquesMean Follow-Up
    Jin et al, 20091542291393330 Mo
    Kai et al, 2011188080824 Mo
    Kashiwazaki et al, 20131373452807356 Mo
    Kim et al, 201171197346625713 Mo
    Luo et al, 2005221001001015 Mo
    Park et al, 20091227111627012 Mo
    Purkayastha et al, 2006238800837 Mo
    Rabinov et al, 2003162621502640 Mo
    Rho et al, 2013245505040 Mo
    Suh et al, 2009251111011015 Mo
    Tsuura et al, 199926121200126 Mo
    Wakhloo et al, 200888268037 Mo
    Wang et al, 20132711382910 Mo
    Yamaura et al, 1999286600612 Mo
    Yoon et al, 2010112461824016 Mo
    Yuki et al, 200517292900295.3 Days
    Zhao et al, 2013105757057027 Mo
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    Table 2:

    Meta-analysis outcomes

    OutcomeAll PatientsDeconstructiveReconstructiveP Deconstructive versus Reconstructive
    Event Rate (95% CI)I2Event Rate (95% CI)I2Event Rate (95% CI)I2
    All patients
        Immediate occlusion75.0 (55.0–88.0)8388.0 (47.0–98.0)8653.0 (31.0–74.0)71<.0001
        Long-term occlusion87.0 (74.0–94.0)8288.0 (35.0–99.0)9181.0 (64.0–91.0)62<.0001
        Perioperative morbidity12.0 (9.0–16.0)012.0 (7.0–18.0)04.0 (2.0–10.0)0.04
        Perioperative mortality8.0 (6.0–11.0)010.0 (6.0–17.0)04.0 (2.0–10.0)0.11
        Recurrence7.0 (5.0–10.0)05.0 (2.0–10.0)05.0 (2.0–11.0)0.89
        Retreatment3.0 (2.0–6.0)05.0 (2.0–10.0)03.0 (1.0–8.0)0.25
        Long-term good clinical outcome84.0 (65.0–94.0)8986.0 (68.0–95.0)6892.0 (86.0–95.0)0.10
    Patients with rupture
        Immediate occlusion78.0 (55.0–91.0)7894.0 (84.0–98.0)043.0 (18.0–73.0)57<.0001
        Long-term occlusion88.0 (83.0–92.0)095.0 (86.0–98.0)083.0 (74.0–90.0)0.02
        Perioperative morbidity16.0 (11.0–22.0)1014.0 (8.0–23.0)07.0 (3.0–17.0)0.82
        Perioperative mortality11.0 (8.0–16.0)013.0 (8.0–22.0)07.0 (3.0–15.0)0.82
        Rebleed9.0 (6.0–13.0)09.0 (4.0–20.0)127.0 (3.0–14.0)0.75
        Recurrence8.0 (5.0–13.0)06.0 (2.0–13.0)07.0 (2.0–17.0)11.00
        Retreatment5.0 (3.0–8.0)06.0 (2.0–13.0)05.0 (2.0–15.0)0.25
        Long-term good clinical outcome79.0 (68.0–87.0)5983.0 (62.0–94.0)6488.0 (79.0–94.0)0.19
    Patients without rupture
        Immediate occlusion80.0 (48.0–94.0)7494.0 (68.0–99.0)2857.0 (25.0–84.0)65<.0001
        Long-term occlusion86.0 (69.0–94.0)6497.0 (81.0–100.0)068.0 (47.0–83.0)31<.0001
        Perioperative morbidity6.0 (3.0–12.0)07.0 (2.0–19.0)07.0 (2.0–19.0)0.58
        Perioperative mortality4.0 (2.0–9.0)04.0 (1.0–18.0)05.0 (1.0–15.0)01.00
        Recurrence7.0 (4.0–13.0)04.0 (1.0–18.0)07.0 (2.0–20.0)01.00
        Retreatment4.0 (2.0–9.0)04.0 (1.0–18.0)05.0 (1.0–15.0)01.00
        Long-term good clinical outcome95.0 (89.0–98.0)093.0 (76.0–98.0)094.0 (84.0–98.0)01.00
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American Journal of Neuroradiology: 36 (7)
American Journal of Neuroradiology
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1 Jul 2015
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Ö. Sönmez, W. Brinjikji, M.H. Murad, G. Lanzino
Deconstructive and Reconstructive Techniques in Treatment of Vertebrobasilar Dissecting Aneurysms: A Systematic Review and Meta-Analysis
American Journal of Neuroradiology Jul 2015, 36 (7) 1293-1298; DOI: 10.3174/ajnr.A4360

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Deconstructive and Reconstructive Techniques in Treatment of Vertebrobasilar Dissecting Aneurysms: A Systematic Review and Meta-Analysis
Ö. Sönmez, W. Brinjikji, M.H. Murad, G. Lanzino
American Journal of Neuroradiology Jul 2015, 36 (7) 1293-1298; DOI: 10.3174/ajnr.A4360
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