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Clinical outcomes of different treatment regimens for vertebrobasilar dolichoectasia: A meta-analysis
Yichun Tang1, Penglin Ren1, Fangyu Yang1
1Neurosurgery Department, Northern Theater Command General Hospital, China.
Objective:
This study aimed to describe the efficacy, clinical outcomes, and complications of open cerebrovascular surgery, endovascular surgery, and conservative treatment for vertebrobasilar dolichoectasia (VBD).
Methods:
In accordance with the PRISMA guidelines, relevant articles were retrieved from databases such as PubMed, Scopus, Web of Science, and CNKI. A meta-analysis was conducted on clinical manifestations, treatment regimens, and clinical outcomes (good (improvement or stabilization of the clinical condition) or poor (deterioration of the clinical condition or death)).
Results:
Eight identified articles described 6 cases (4.15 %) of open cerebrovascular surgery, 112 cases (76.7 %) of endovascular surgery, and 28 cases (19.2 %) of conservative treatment for VBD. The good outcome rate in the total cohort was 76 % (95 % CI 0.59-0.90 %), and the poor outcome rate was 22 % (95 % CI 9-39 %). The clinical outcome rates in the treatment groups were as follows: relatively good (endovascular surgery group: 69.0 % [95 % CI 50-85 %]; conservative treatment group: 43 % [95 % CI 27.0-60 %]; P < 0.01), and relatively poor (endovascular surgery group: 27.2 % [95 % CI 5-38 %]; conservative treatment group: 24 % [95 % CI 11-40 %]; P < 0.01).
Conclusion:
Endovascular surgery has certain advantages in improving the clinical outcomes of VBD patients, but attention should also be paid to the potential risks it may bring. Although the effect of conservative treatment is relatively weak, it still has certain therapeutic value for some patients. However, given the limitations of current research, further in depth and large-sample studies are needed in the future to optimize the treatment strategy for VBD.
