Vertebrobasilar dolichoectasia future aspects: A meta-analysis of clinical features and treatment strategies

Nour Shaheen; Santiago Ortega-Gutierrez; Edgar A Samaniego; Panagiotis Mastorakos; Michael Reid Gooch; Pascal Jabbour; Oliver Flouty; Kathleen Dlouhy; Mario Zanaty

doi:10.1177/15910199251380385

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Vertebrobasilar dolichoectasia future aspects: A meta-analysis of clinical features and treatment strategies

Journal article

Peer reviewed

Vertebrobasilar dolichoectasia future aspects: A meta-analysis of clinical features and treatment strategies

Nour Shaheen, Santiago Ortega-Gutierrez, Edgar A Samaniego, Panagiotis Mastorakos, Michael Reid Gooch, Pascal Jabbour, Oliver Flouty, Kathleen Dlouhy and Mario Zanaty

Interventional neuroradiology

09/29/2025

DOI: 10.1177/15910199251380385

PMCID: PMC12479457

PMID: 41021786

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https://pmc.ncbi.nlm.nih.gov/articles/PMC12479457/View

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Abstract

Background Dolichoectatic vertebrobasilar fusiform aneurysm (DVBFA) presents a clinical challenge due to its complex anatomical features and associated neurological complications. This meta-analysis evaluates the clinical outcomes of endovascular therapy (EVT), open surgery, and conservative management for DVBFA. Methods A systematic review of the PubMed, Scopus, and Web of Science databases on July 18, 2024 was conducted to identify studies reporting on radiologically confirmed DVBFAs. Clinical outcomes were assessed using the modified Rankin Scale (mRS) and mortality rates. Meta-regression was performed to identify potential predictors of treatment outcomes. Results Ten studies with 219 patients were analyzed. Of the cohort, 58.4% underwent EVT, 24.6% received open surgery, and 16.9% were managed conservatively. The overall proportion of patients achieving a good clinical outcome (mRS < 3) was 46.8%, with EVT showing the highest proportion at 59.4%, compared to 32.3% for open surgery and 24.7% for conservative management (p = 0.0145). The overall mortality rate was 25.98%, with EVT having the lowest mortality rate at 10.06%, followed by open surgery at 44.44% and conservative management at 63.30% (p = 0.0004). Pre- versus post-treatment subgroup analyses, however, did not reveal significant differences between treatment approaches in outcomes. Conclusion EVT appears to provide better clinical outcomes for DVBFAs, though mortality rates remain high across all treatment modalities. The absence of significant differences in subgroup analysis suggests the need for further randomized controlled trials of EVT versus conservative management to establish definitive treatment guidelines.

bypass

EVT

endovascular

conservative management

flow diversion

open surgery

Vertebrobasilar dolichoectasia

dolichoectatic vertebrobasilar fusiform aneurysms

DVBFAs

Details

Title: Subtitle: Vertebrobasilar dolichoectasia future aspects: A meta-analysis of clinical features and treatment strategies
Creators: Nour Shaheen - Alexandria University
Santiago Ortega-Gutierrez - University of Iowa
Edgar A Samaniego - University of Iowa
Panagiotis Mastorakos - Thomas Jefferson University Hospital
Michael Reid Gooch - Thomas Jefferson University Hospital
Pascal Jabbour - Thomas Jefferson University Hospital
Oliver Flouty - University of South Florida
Kathleen Dlouhy - University of Iowa
Mario Zanaty - University of Iowa
Resource Type: Journal article
Publication Details: Interventional neuroradiology
DOI: 10.1177/15910199251380385
PMID: 41021786
PMCID: PMC12479457
NLM abbreviation: Interv Neuroradiol
ISSN: 2385-2011
eISSN: 2385-2011
Publisher: SAGE PUBLICATIONS INC
Language: English
Electronic publication date: 09/29/2025
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984966702602771

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