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Microvascular decompression (MVD) is considered the most definitive treatment; however, outcomes in this subgroup remain incompletely characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed, Embase, Scopus, and Web of Science were searched from inception through August 22, 2025. Eligible studies reported on patients with VBD-TN undergoing MVD with extractable data on pain outcomes, recurrence, salvage interventions, or complications. Complete relief was defined as Barrow Neurological Institute (BNI)-I, while adequate relief included BNI-I to IIIb.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen studies involving 315 patients were analyzed. The mean age ranged from 54.0 to 67.3\u00a0years, with 57.8% (182\/315) being males. The pooled initial complete pain relief rate was 95.8% (95% CI, 92.3\u201398.2), with sustained relief at the last follow-up in 92.6% (95% CI, 88.4\u201396.1). Adequate relief was nearly universal, at 99.9% (95% CI, 98.2\u2013100%) initially and 95.9% (95% CI, 91.8\u201398.8%) at the last follow-up. Pain recurrence occurred in 5.5% (95% CI, 2.9\u20138.9%), and salvage procedures were required in 1.3% (95% CI, 0.2\u20133.1%). The permanent morbidity was low at 2.4% (95% CI, 0.8\u20134.8%). Meta-regression indicated that prior ablative procedures were associated with higher complication rates, whereas V2 involvement predicted better long-term pain control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MVD appears to provide effective and durable pain relief for selected patients with VBD-TN, with low permanent morbidity but a clinically meaningful overall complication burden. Given the retrospective nature of the available evidence, MVD should be considered a promising treatment option rather than a definitive standard of care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-026-06925-0","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T13:44:31Z","timestamp":1779975871000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"168","author":[{"given":"Bardia","family":"Hajikarimloo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Mohammadzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salem M.","family":"Tos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Amin","family":"Habibi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadmahdi","family":"Sabahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badih","family":"Adada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Borghei-Razavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"6925_CR1","doi-asserted-by":"publisher","first-page":"e1395","DOI":"10.1016\/j.wneu.2022.09.049","volume":"167","author":"K Amagasaki","year":"2022","unstructured":"Amagasaki K, Takusagawa Y, Tatebayashi K, Nakaguchi H (2022) Macrovascular decompression with the transposition method using Teflon sling for trigeminal neuralgia caused by the vertebrobasilar artery. 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