Universidad Peruana Cayetano Heredia

Microsurgical and endovascular treatment of posterior inferior cerebellar artery aneurysms: a systematic review and meta-analysis

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dc.contributor.author Saal-Zapata, G.
dc.contributor.author Rodriguez-Calienes, A.
dc.contributor.author Malaga, M.
dc.contributor.author Velasquez-Rimachi, V.
dc.contributor.author Moran, C.
dc.contributor.author Bustamante-Paytan, D.
dc.contributor.author Pacheco Barrios, Niels Victor
dc.contributor.author Pacheco-Barrios, K.
dc.contributor.author Alva-Diaz, C.
dc.contributor.author Walker, M.
dc.date.accessioned 2023-12-05T17:48:02Z
dc.date.available 2023-12-05T17:48:02Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14648
dc.description.abstract INTRODUCTION: Posterior inferior cerebellar artery (PICA) aneurysms are uncommon vascular lesions of the posterior fossa. In addition to aneurysmal morphology, structural anatomic considerations may confer additional procedural risk, and as a result there is currently no consensus as to whether a surgical or endovascular approach offers greater safety and efficacy for patients. EVIDENCE ACQUISITION: We systematically examined peer-reviewed literature describing PICA aneurysm treatment planning from January 2000 to May 2021 using the PRISMA methodology. A meta-analysis of proportions was performed. Certainty of the evidence was assessed using the GRADE approach. EVIDENCE SYNTHESIS: Fifty-eight studies including 1673 PICA aneurysms were analyzed. Overall treatment occlusion rate was 97% (95% confidence interval [CI]: 93-100%) for surgery and 85% (95% CI: 78-92%) for endovascular therapy. The recurrence rate was 6% in the endovascular group and 1% for surgery. Overall morbidity and mortality were 16% and 7%, respectively. Intraoperative complications occurred in 9% of the surgical patients. CONCLUSIONS: Despite a large body of literature, analysis indicates that 62% of studies had moderate or serious risk of bias, suggesting very-low certainty results. Therefore, treatment via either approach should be determined on a case-by-case basis and according to institutional experience. en_US
dc.language.iso eng
dc.publisher Edizioni Minerva Medica
dc.relation.ispartofseries Journal of Neurosurgical Sciences
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Aneurysm en_US
dc.subject Endovascular procedures en_US
dc.subject Microsurgery en_US
dc.subject.mesh Aneurisma
dc.subject.mesh Procedimientos Endovasculares
dc.subject.mesh Microcirugia
dc.title Microsurgical and endovascular treatment of posterior inferior cerebellar artery aneurysms: a systematic review and meta-analysis en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.23736/S0390-5616.22.05710-1
dc.relation.issn 1827-1855


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