{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:30:20Z","timestamp":1787610620166,"version":"build-2736575974"},"reference-count":31,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2016,4,29]]},"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Different endovascular modalities have been applied to the treatment of vertebral artery dissecting aneurysms, the most commonly used being internal trapping and stent-assisted coiling, although the ideal treatment remains controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To perform a meta-analysis to study clinical outcomes of patients with vertebral artery dissecting aneurysms who were treated with internal trapping or stent-assisted coiling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We conducted a meta-analysis of eight retrospective studies that compared internal trapping with stent-assisted coiling for the treatment of vertebral artery dissecting aneurysms. The primary outcomes of this study were immediate occlusion, long-term occlusion, good outcome ratio, perioperative mortality, and angiographic recurrence. Subgroup analyses were conducted of patients with ruptured versus unruptured vertebral artery dissecting aneurysms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight studies comprising a total of 188 patients were included in the analysis. For ruptured cases, in comparison with stent-assisted coiling groups, the patients treated with trapping techniques had a higher rate of immediate postoperative occlusion (OR=0.165; 95% CI 0.067 to 0.405; p&lt;0.01), although there was no significant difference in long-term occlusion (OR=1.059; 95% CI 0.033 to 34.121; p=0.974), good clinical outcome rates, recurrence rates, and perioperative mortality. For unruptured cases, patients in the trapping groups also had higher immediate occlusion rates than those who underwent stent-assisted coiling (OR=0.175; 95% CI 0.043 to 0.709; p=0.015), while rates of both recurrence and good clinical outcome were similar between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both internal trapping and stent-assisted coiling are technically feasible for ruptured vertebral artery dissecting aneurysms, with high rates of good long-term neurologic outcomes and low recurrence and mortality rates. For unruptured aneurysms, conservative treatment is recommended. When a posterior inferior cerebellar artery (PICA) origin is involved, bypass surgery or vertebral artery-to-PICA stent placement plus coil embolization should be considered.<\/jats:p><\/jats:sec>","DOI":"10.1136\/neurintsurg-2016-012309","type":"journal-article","created":{"date-parts":[[2016,5,25]],"date-time":"2016-05-25T03:03:02Z","timestamp":1464145382000},"page":"558-563","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Endovascular treatment for ruptured and unruptured vertebral artery dissecting aneurysms: a meta-analysis"],"prefix":"10.1136","volume":"9","author":[{"given":"Jian","family":"Guan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyi","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwu","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongqi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renzhi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,5,24]]},"reference":[{"key":"2024052303082576000_9.6.558.1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e3182012323"},{"key":"2024052303082576000_9.6.558.2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199505000-00003"},{"key":"2024052303082576000_9.6.558.3","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3873"},{"key":"2024052303082576000_9.6.558.4","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1007\/s00270-014-0981-3","article-title":"Treatment of ruptured vertebral artery dissecting aneurysms distal to the posterior inferior cerebellar artery: stenting or trapping?","volume":"38","author":"Fang","year":"2015","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2024052303082576000_9.6.558.5","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1621"},{"key":"2024052303082576000_9.6.558.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-006-0742-4"},{"key":"2024052303082576000_9.6.558.7","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2087"},{"key":"2024052303082576000_9.6.558.8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.5469\/neuroint.2015.10.1.14","article-title":"Endovascular treatment of intracranial vertebral artery dissecting aneurysms: follow up angiographic and clinical results of endovascular treatment in serial cases","volume":"10","author":"Shin","year":"2015","journal-title":"Neurointervention"},{"key":"2024052303082576000_9.6.558.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2011.03.034"},{"key":"2024052303082576000_9.6.558.10","first-page":"529","article-title":"Endovascular treatment for dissecting aneurysms in vertebral artery","volume":"16","author":"Mu","year":"2011","journal-title":"Chin J Minim Invasive Neurosurg"},{"key":"2024052303082576000_9.6.558.11","first-page":"529","article-title":"Endovascular treatment of vertebral artery dissecting aneurysms","volume":"22","author":"You","year":"2013","journal-title":"J Intervent Radiol"},{"key":"2024052303082576000_9.6.558.12","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s10143-014-0541-y","article-title":"Clinical outcomes of patients with vertebral artery dissection treated endovascularly: a meta-analysis","volume":"37","author":"Hernandez-Duran","year":"2014","journal-title":"Neurosurg Rev"},{"key":"2024052303082576000_9.6.558.13","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.6.880"},{"key":"2024052303082576000_9.6.558.14","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1972.00490170024004"},{"key":"2024052303082576000_9.6.558.15","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-006-0272-8"},{"key":"2024052303082576000_9.6.558.16","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1177\/159101991001600208","article-title":"Dissection of the distal vertebral artery treated by modified parent artery trapping and a contralateral stent barricade. 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