Neuroradiology Journal最新文献

{"title":"De novo cerebrospinal fluid-venous fistula following multilevel blood and fibrin patching for spontaneous intracranial hypotension.","authors":"Bikei Ryu, Timo Krings, Neil V Patel, Jonathan Pace, Emanuele Orru","doi":"10.1177/19714009261445614","DOIUrl":"10.1177/19714009261445614","url":null,"abstract":"<p><p>Treated cerebrospinal fluid-venous fistulas (CVFs) can recur in up to 15% of cases, and they rarely occur at locations remote from the original lesion; the underlying mechanisms remain unclear. We report the case of a male sexagenarian with spontaneous intracranial hypotension (SIH), diffuse spinal nerve root diverticula, and no CVF identified on baseline lateral decubitus CT myelography (CTM). He underwent high-volume epidural and targeted transforaminal blood and fibrin patching with substantial but incomplete symptom relief, followed by transient rebound intracranial hypertension (RIH). Repeat CTM after symptom recurrence demonstrated a new right T5 CVF arising from a remodeled diverticulum and draining into the azygos system. The fistula was successfully treated with transvenous embolization, resulting in sustained clinical and radiological resolution. This case illustrates that in patients with multilevel diverticula, possibly representing connective tissue weakness, post-treatment pressure shifts (including RIH and other causes of episodic cerebrospinal fluid hypertension) may promote the formation or unmasking of CVFs.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261445614"},"PeriodicalIF":1.2,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of middle cerebral artery atherosclerotic stenosis using 7T high-resolution MRI and time-of-flight MRA: A comparative analysis with DSA.","authors":"Danyang Fan, Jiafei Chen, Fei Chen, Fengwei Ye, Simin Xia, Runyu Jing, Min Wu, Meng Zuo, Zhenhua Zhou","doi":"10.1177/19714009261438428","DOIUrl":"10.1177/19714009261438428","url":null,"abstract":"<p><p>BackgroundIschemic stroke, often caused by intracranial atherosclerotic stenosis (ICAS), is a leading cause of disability and death globally. 7T MRI offers improved signal-to-noise ratio (SNR) and contrast, enhancing MRA image quality. This study assessed the accuracy of 7T high-resolution (HR) MRI and time-of-flight MRA (TOF-MRA) in measuring middle cerebral artery (MCA) stenosis compared to digital subtraction angiography (DSA).MethodsIn this prospective observational study, patients, diagnosed with MCA atherosclerotic stenosis, underwent 7T HR-MRI, TOF-MRA and DSA. Spearman correlation analysis was used to assess the linear correlation between HR-MRI, TOF-MRA, and DSA measurements of MCA stenosis. Agreement for stenosis classification data was evaluated using weighted kappa values. Receiver Operating Characteristic (ROC) curves were utilized to predict severe stenosis and occlusion of MCA in HR-MRI and TOF-MRA.ResultsThis study included 86 lesions from 81 patients with MCA atherosclerotic stenosis. The stenosis degree measurements between 7T HR-MRI and DSA indicated a very strong correlation (r = 0.8000; <i>p</i> < .0001). The correlation between 7T TOF-MRA and DSA assessments was high (r = 0.7188; <i>p</i> < .001). A robust correlation between 7T HR-MRI and TOF-MRA evaluations was shown (r = 0.839; <i>p</i> < .0001). 7T TOF-MRA (K = 0.673) demonstrated substantial agreement with DSA measurements, showing slight superiority over HR-MRI (K = 0.589). ROC analysis indicated both 7T HR-MRI and TOF-MRA effectively predicted severe MCA stenosis and occlusion (HR-MRI, AUC: 0.888; TOF-MRA, AUC: 0.878).Conclusions7T HR-MRI and TOF-MRA may emerge as comparable modalities for assessing MCA atherosclerotic stenosis, and HR-MRI allows for precise evaluation through direct visualization of the vessel lumen and plaque.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261438428"},"PeriodicalIF":1.2,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular or microsurgical? Defining the best approach for blood blister aneurysms: A comparative meta-analysis.","authors":"Filipi Fim Andreão, Helvécio Neves Feitosa Filho, Emanuel Abrantes Barros, José Gabriel Abreu Moreira, Matheus Hemais, Ary Rodrigues Neto, Luiz Guilherme Silva Almeida, Niels Pacheco-Barrios, Thayne Alexsandra Carneiro, Vitor Salviato Nespoli, Fausto Braga, Cesar Augusto Alves Ferreira Filho, Elias Tanus, José Alberto Almeida Filho","doi":"10.1177/19714009251346467","DOIUrl":"10.1177/19714009251346467","url":null,"abstract":"<p><p>IntroductionBlood blister-like aneurysms (BBLAs) are rare, typically found in the anteromedial supraclinoid segment of the internal carotid artery, and are related to high morbidity and mortality rates. Although microsurgery has been traditionally used to manage BBLAs, the Endovascular treatment (EVT) is gaining importance. We aim to compare these two methods using a systematic review and meta-analysis.MethodsA systematic search of PubMed, Embase, and Web of Science databases following PRISMA guidelines was conducted. We pooled odds ratios (OR) with 95% confidence intervals using a random-effects model, and I² to assess heterogeneity. Eligible studies compared microsurgery and EVT for BBLAs. Outcome measures included Good and Poor clinical outcomes by Modified Rankin Scale (mRS), Epilepsy, Infection, Intracranial Hemorrhage, Vasospasm, Ischemic Events, Mortality, Operative Rupture, Rebleeding, Recurrence, and Retreatment.ResultsFifteen studies with 770 patients were included (401 microsurgery; 369 EVT). EVT appeared to be protective against Poor Clinical Outcomes (mRS >2), with an OR of 0.43 (95% CI 0.21 to 0.87), and Ischemic Events, having an OR of 0.33 (95% CI 0.18 to 0.61). Microsurgery was related to higher Mortality, with an OR of 2.72 (95% CI 1.46 to 5.06), and Operative Rupture, with 7.72 (95% CI 3.50 to 17.07). EVT also statistically favored the Good Clinical Outcomes analysis, with an OR of 3.13 (95% CI 1.40 to 6.98). Epilepsy, Infection, Intracranial Hemorrhage, and Vasospasm occurrence showed no significant statistical difference.ConclusionDespite microsurgery being traditionally used in BBLAs management, EVT has been shown to be a safer and lower-morbidity option.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"137-151"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the diagnostic accuracy of AI in ischemic and hemorrhagic stroke: A comprehensive meta-analysis.","authors":"Neeraj Gul, Yumna Fatima, Hamid Saeed Shaikh, Maham Raheel, Arslan Ali, S Umar Hasan","doi":"10.1177/19714009251373062","DOIUrl":"10.1177/19714009251373062","url":null,"abstract":"<p><p>Stroke poses a significant health challenge, with ischemic and hemorrhagic subtypes requiring timely and accurate diagnosis for effective management. Traditional imaging techniques like CT have limitations, particularly in early ischemic stroke detection. Recent advancements in artificial intelligence (AI) offer potential improvements in stroke diagnosis by enhancing imaging interpretation. This meta-analysis aims to evaluate the diagnostic accuracy of AI systems compared to human experts in detecting ischemic and hemorrhagic strokes. The review was conducted following PRISMA-DTA guidelines. Studies included stroke patients evaluated in emergency settings using AI-Based models on CT or MRI imaging, with human radiologists as the reference standard. Databases searched were MEDLINE, Scopus, and Cochrane Central, up to January 1, 2024. The primary outcome measured was diagnostic accuracy, including sensitivity, specificity, and AUROC and the methodological quality was assessed using QUADAS-2. Nine studies met the inclusion criteria and were included. The pooled analysis for ischemic stroke revealed a mean sensitivity of 86.9% (95% CI: 69.9%-95%) and specificity of 88.6% (95% CI: 77.8%-94.5%). For hemorrhagic stroke, the pooled sensitivity and specificity were 90.6% (95% CI: 86.2%-93.6%) and 93.9% (95% CI: 87.6%-97.2%), respectively. The diagnostic odds ratios indicated strong diagnostic efficacy, particularly for hemorrhagic stroke (DOR: 148.8, 95% CI: 79.9-277.2). AI-Based systems exhibit high diagnostic accuracy for both ischemic and hemorrhagic strokes, closely approaching that of human radiologists. These findings underscore the potential of AI to improve diagnostic precision and expedite clinical decision-making in acute stroke settings.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"188-196"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical classification of septum pellucidum variations and analysis of the co-occurrence of the variations with psychiatric disorders.","authors":"Bilge Kuru, Istemihan Coban, Fulya Yaprak, Osman Hasan Tahsin Kilic, Orkun Sarioglu, Berna Dirim Mete","doi":"10.1177/19714009251351290","DOIUrl":"10.1177/19714009251351290","url":null,"abstract":"<p><p>This study sought to categorize anatomical variations of the septum pellucidum (SP), cavum vergae (CV), and cavum veli interpositi (CVI), as well as to examine potential correlations between these variations and psychiatric disorders. A total of 2949 patients were retrospectively analyzed utilizing brain MRIs. Variations were categorized into nine types according to the coexistence of CSP and CVI in either mild or moderate manifestations. The prevalence of CSP, CV, and CVI in the study population was 7.9%, 1.4%, and 9.0%, respectively, with an overall occurrence of variation at 13.8%. A chi-square test indicated a significant correlation between moderate CSP with mild CVI (Type VIII) and a reduced prevalence of psychiatric disorders (<i>p</i> = .007), implying a possible protective effect. Nevertheless, the majority of SP variations exhibited no statistically significant correlation with psychiatric diagnoses, including schizophrenia, OCD, or bipolar disorder. Logistic regression analysis revealed a significant interaction between gender and SP variations in predicting psychiatric disorders, with females exhibiting a higher overall prevalence. The interaction term was statistically significant (<i>p</i> < .001), suggesting that variations in SP and gender collectively affect the probability of psychiatric disorders. The findings offer valuable insights; however, limitations including the retrospective design, small subgroup sizes, and absence of genetic data necessitate caution in result interpretation. This study enhances comprehension of SP variations and their possible involvement in psychiatric disorders, emphasizing the necessity for additional research to clarify the underlying neurobiological mechanisms and clinical ramifications.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"216-221"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with post-dural puncture headache: A single-center retrospective review.","authors":"Rahim Ismail, Denes Szekeres, Alex Schick, Muhammad I Jalal, Tim Hoang, Aman Preet Singh, Nate French, Logan Worley, Casey Paton, Mark Manganaro, Derrek Schartz, Derek George, Alexander Kessler","doi":"10.1177/19714009251345109","DOIUrl":"10.1177/19714009251345109","url":null,"abstract":"<p><p>ObjectivePost-dural puncture headache (PDPH) is potential complication after procedures with dural puncture. This study analyzes how patient and procedural factors are related to the development of PDPH.MethodsDemographic and procedural data were extracted from the electronic medical record in patients undergoing a dural puncture procedure from 1/1/2020 to 12/31/2020. Procedural variables were extracted from procedure reports including spinal level, number of punctures, any reported complications, needle type, and gauge. Fisher-exact test, with a subgroup analysis, and multivariable logistic regression were used to analyze the association of variables with the development of a PDPH.ResultsA total of 1237 procedures with 1005 patients were identified. The mean age was 56.9 ± 16.4 years, mean BMI was 31.0 ± 7.8 kg/m², and 534 (53.1%) identified as female. Seventy-four (7.3%) patients developed a PDPH with mean onset of 1.9 ± 1.9 days post-procedure. The likelihood of PDPH was significantly positively associated with both patient characteristics such as female sex (OR = 2.657, 95%CI [1.529,4.617], <i>p</i> < .001), BMI above 25 kg/m² (OR = 2.609, 95%CI [1.177,5.786], <i>p</i> = .015), and history of chronic tension headaches (OR = 2.943, 95%CI [1.688,5.130], <i>p</i> < .0003), as well as procedural characteristics such as decreasing gauge (OR = 1.124, 95%CI [1.111,1.136], <i>p</i> < .0001), higher opening pressure (mean difference = -6.288 ± 2.119. <i>p</i> = .005).ConclusionsThis retrospective study of fluoroscopy-guided dural puncture procedures shows that the incidence of PDPH is associated with several patient and procedural characteristics.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"231-237"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of a giant developmental venous anomaly and acute disseminated encephalomyelitis: A case report and magnetic resonance perfusion study.","authors":"Louis Deprez, Emilie Lommers","doi":"10.1177/19714009251356989","DOIUrl":"10.1177/19714009251356989","url":null,"abstract":"<p><p>We describe the first reported association between acute disseminated encephalomyelitis (ADEM) and giant developmental venous anomaly (DVA) in the context of myelin oligodendrocyte associated glycoprotein (MOG) associated disorder (MOGAD). Patient was a young woman presenting with headache, bradypsychia and tetrapyramidal syndrome. Imaging showed disseminated tumefactive inflammatory lesions in the brain and spinal cord, with a massive right frontal lobe lesion centred around a giant DVA. Demyelinating inflammatory lesions are known to occur in a perivenular pattern, and the association between some inflammatory diseases such as multiple sclerosis (MS) and DVA has already been described. Developmental venous anomalies are variant of the normal venous drainage of the brain, responsible of a local alteration of the venular network, and micro-perfusion anomalies as well as possible increased of blood-brain barrier permeability. As such, they might be responsible for a favourable environment for pathogenic auto-antibodies penetrance in such region, potentializing the inflammatory lesion size. Perfusion imaging showed a significant increase in regional blood volume and blood transit time in the DVA and the surrounding brain tissue, which regressed in the follow-up imaging studies after the acute stage. This case illustrates the potential role of DVA in the setting of demyelinating diseases, and its consequences on the local micro-perfusion of the brain, evolving between the acute and chronic phase of the illness.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"261-265"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging and clinical course of metastatic pituitary neuroendocrine tumors (PitNET): A single center case series.","authors":"Samir A Dagher, Sahar Alizada, Heba Al Qudah, Steven G Waguespack, Komal B Shah, Rami W Eldaya","doi":"10.1177/19714009251356278","DOIUrl":"10.1177/19714009251356278","url":null,"abstract":"<p><p>PurposeMetastatic pituitary neuroendocrine tumors (PitNET) are exceedingly rare tumors that are typically diagnosed at the time of metastasis. Given the rarity of metastatic PitNET tumors, the pattern of metastasis and imaging appearance of CNS and extra neural metastasis is under reported and poorly understood.MethodsIn this retrospective case series, we present 14 consecutive patients with pathology-confirmed metastatic PitNET tumors. We assess imaging features of primary pituitary disease at the time of diagnosis, temporal evolution of local disease, and distant metastasis on multimodality imaging. We also explore potential association of initial pathology diagnosis and time to metastasis and survival.ResultsAt the time of metastasis, nine patients had evidence of disease in the sella and three additional had evidence of disease in the cavernous sinus. The most common site of metastatic disease was the CNS (78.6%). Dural deposits were the most common brain CNS metastatic disease manifestation (81.8%). Eight patients (57.1%) demonstrated multiple metastatic disease sites, with five of them (62.5%) showing both CNS and extra CNS metastases. Osseous metastatic disease was the most common extra CNS disease site (75.0%). Median time to metastasis did not significantly differ between patients with adenoma and those with more aggressive pathologies at initial diagnosis (<i>p</i> value = .39). Similarly, median overall survival from metastasis detection was not significantly affected by pathology (<i>p</i> value = .84).ConclusionMetastatic PitNET is a rare neuroendocrine neoplasm. In the present case series, we detail temporal imaging findings of the disease at the primary site and patterns of metastasis.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"222-230"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing clot composition analysis in acute ischemic stroke with non-contrast spectral CT: A phantom-based study.","authors":"Juyu Chueh, Gregor Pahn, Charlie Shin, Michael Cleri, Emanuele Orrù, Neil Patel, Jonathan Pace, Timo Krings, Sebastian Flacke, Christoph Wald","doi":"10.1177/19714009251356994","DOIUrl":"10.1177/19714009251356994","url":null,"abstract":"<p><p>Acute ischemic stroke (AIS), caused by blood flow obstruction due to a clot, is a leading medical emergency, with mechanical thrombectomy (MT) being the standard of care intervention. The success of MT partly depends on the ability to effectively assess clot composition, as different clot types (e.g., erythrocyte-rich and fibrin-rich) can influence treatment outcomes. Conventional CT imaging struggles with accurately differentiating clot subtypes. Recent advancements in spectral CT imaging offer promising alternatives, but their diagnostic value remains underexplored. This study evaluates the potential of using electron density (ED) and effective atomic number (Z-effective) maps from non-contrast spectral CT (NCCT), that is, without iodine contamination for classifying clot compositions in a phantom model. Two experimental phases were conducted, with various clot analogs prepared in silicone tubes of varying diameters. Spectral CT scans were performed using a dual-layer detector system, generating conventional CT, ED, and Z-effective maps, along with virtual monoenergetic (MonoE) images. Our results revealed that ED and high-energy MonoE images (200 keV) provided superior discrimination of clot types, with larger effect sizes and higher area-under-curve (AUC) values compared to conventional CT and low-energy MonoE (40 keV) or Z-effective maps. These findings suggest that ED and high MonoE images enhance clot characterization and may improve treatment planning in AIS. However, smaller tube diameters and the inclusion of skull-equivalent material in the phantom model reduced the sensitivity and specificity of the spectral methods. This study highlights the potential of spectral CT to refine clot assessment in AIS, emphasizing the need for further clinical validation.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"238-246"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing efficacy and safety of direct aspiration versus stent retriever thrombectomy in acute basilar artery occlusion: A systematic review and meta-analysis.","authors":"Muhammad Hassan Waseem, Zain Ul Abideen, Kanza Farhan, Haseeb Javed Khan, Dua Ghori, Misha Ahmed, Muhammad Burhan Tariq, Sania Aimen, Muhammad Wajih Ansari, Rowaid Ahmad, Zara Fahim","doi":"10.1177/19714009251371266","DOIUrl":"10.1177/19714009251371266","url":null,"abstract":"<p><p>Acute basilar artery occlusion (BAO) can lead to severe stroke and is linked to significant disability or death if not treated. This meta-analysis evaluated the effectiveness and safety of first-line thrombectomy options: Direct Aspiration (DA) and Stent Retriever Thrombectomy (SRT) for acute BAO. Electronic databases, including PubMed, Cochrane Central, ScienceDirect, Embase, and Web of Science were searched from inception until July 2025. Studies were included if they were RCTs or observational cohorts involving adults with acute BAO, comparing DA and SRT. The risk ratios (RR) and mean differences (MD) were pooled using Review Manager version. The Newcastle-Ottawa Scale (NOS) was used to assess quality. This meta-analysis included fifteen observational studies pooling 2214 patients. DA significantly increased the postoperative successful (RR = 1.04; 95% CI: 1.01 to 1.07; <i>p</i> = 0.008) and complete (RR = 1.19; 95% CI: 1.03 to 1.38; <i>p</i> = 0.02) recanalization compared to SRT. Similarly, symptomatic intracerebral hemorrhage (sICH) incidence was significantly reduced in the DA arm (RR = 0.65; 95% CI: 0.44 to 0.97; <i>p</i> = 0.04). DA is also associated with decreased procedural duration (MD = -35.17 min; 95% CI: -47.97 to -22.37; <i>p</i> < 0.00001). Meanwhile other outcomes, including postoperative mortality, rescue therapy, and favorable functional outcome were comparable between the 2 groups. DA demonstrated superior recanalization rates, reduced procedural duration, and a lower incidence of sICH compared to SRT. However, both techniques were comparable regarding other outcomes. Nevertheless, the observational study design limits the strength of the conclusion drawn.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"163-173"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}