Abstract Background Due to the complex anatomical structure surrounding the basilar artery trunk, basilar trunk aneurysms (BTAs) can result in severe complications and poor prognosis for patients. The treatments for BTAs still remain challenging and uncertain. Methods We conducted a comprehensive search of Embase, MEDLINE, Cochrane Library databases using medical subject headings and free-text terms, with the last search completed on July 1st, 2024. Both single-arm and two-arm meta-analysis were performed to compare the safety and effectiveness of different treatments for BTAs. Both fixed-effects models and random-effects models were calculated. When the heterogeneity was over 50%, we chose the random-effects model. Results We identified 21 studies enrolling 593 participants and 599 aneurysms. The summary favorable outcome proportion was 0.46 (95% CI: 0.303 to 0.625) for open surgery and 0.75 (95% CI: 0.671 to 0.819) for endovascular treatments in the random-effects model, as the I 2 for heterogeneity was 66% ( P 0.05). Conclusion No statistically significant difference was observed between the open surgery and endovascular treatments. The mortality and complication outcomes revealed no distinctions between the two subgroups, regardless of whether direct or indirect comparisons was conducted. The influence of institutional expertise emerged as a critical factor in treatment outcomes. Furthermore, more effective controls and larger sample size are required to achieve more credible and conclusive results.
Tian et al. (Tue,) studied this question.