P095 Treatment of vertebral artery dissecting aneurysms with flow diversion: a comparative systematic review and meta-analysis

<h3>Introduction</h3> Intracranial vertebral artery dissecting aneurysms (VADAs) are rare and complex. Treatment strategies remain debated due to the involvement of branching arteries. <h3>Aim of Study</h3> This study was conducted to assess the safety and efficacy of flow diversion (FD) compared to alternative methods for VADAs through systematic review and meta-analysis. <h3>Methods</h3> In December 2023, we conducted a systematic search in Pubmed, Scopus, and Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our objective was to compare occlusion rates, favorable mRS (0-2), and complication rates. Additionally, we directly compared the FD group with other interventions. We employed a weighted random-effect model for meta-analysis. <h3>Results</h3> 23 articles and 422 patients were included. The immediate occlusion rate was 5.8% for FD, which is significantly lower than stenting methods (OR= 0.03, <i>P</i> value&lt; 0.0001). The final complete occlusion rate was 79.87% similar to the stenting group (OR= 1.01, <i>P</i> value= 0.98) and lower than deconstructive treatment (OR= 0.16, <i>P</i> value= 0.005). Favorable mRS was recorded in 95.31% which was comparable to the stenting group (OR= 1.57, <i>P</i> value= 0.47), but significantly higher compared to the deconstructive group (OR= 4.27, <i>P</i> value= 0.002). Complication rates were low (9.7%) without a significant difference compared to the other two groups (<i>P</i> value= 0.19, <i>P</i> value= 0.68). Adverse events were reported in 17.3% when the posterior inferior cerebellar artery was covered by FDs. <h3>Conclusion</h3> This study highlights FDs as a potentially effective initial treatment choice for VADAs, especially for unruptured cases. <h3>Disclosure of Interest</h3> no.