Association Between Vertebral Artery Hypoplasia And Posterior Circulation Infarction:a Meta-analysis

BackgroundCerebral infarction is the most common type of stroke,in which posterior circulation infarction is more serious.Posterior circulation infarction is a severe disease with poor prognosis,which give the patients suffering.Therefore,identifying the risk factors of posterior circulation infarction is especially important.With the development of medical imaging,people have a deep understanding of posterior circulation infarction.The role of vertebral artery hypoplasia in posterior circulation infarction was gradually concerned by clinicians.During the past decades,many scholars explored the relationship between vertebral artery hypoplasia and posterior circulation ischemic stroke.Most studies have shown that vertebral artery hypoplasia is a risk factor of posterior circulation infarction,but a few studies argue that vertebral artery hypoplasia is not a predisposing factor for stroke or it cannot increase the risk of posterior circulation infarction,generating inconsistent results.In this study,A Meta-analysis of relevant studies was performed to know more about the relationship between vertebral artery hypoplasia and posterior circulation infarction.ObjectiveTo evaluate the association between vertebral artery hypoplasia and posterior circulation infarction.MethodsWe searched PubMed,EBSCO Host,CBM,CNKI and Wanfang Database up to February 2017 to identify the related studies about the relationship between vertebral artery hypoplasia and posterior circulation infarction.All the studies were strictly screened according to the inclusion and exclusion criteria by 2 authors.The analyses were conducted for the included studies using Stata 12.0 software after the quality evaluation and data extraction.Sensitivity analysis was used to evaluate the stability of the results.The publication bias was estimate by Begg rank correlation method and Egger linear regression method.ResultsA total of 10 articles were included.There were 3 Chinese articles and 7 English articles,including a total of 5841 subjects.The results of meta-analyses showed:There was no significant heterogeneity between 10 studies when the vertebral artery hypoplasia was defined by vertebral artery?2-3 mm in diameter(I~2=17.7%,P=0.280),a fixed effects model was used.The overall result showed that the vertebral artery hypoplasia rate was significant difference[OR=2.42,95%CI(2.10,2.80)].There was also no significant heterogeneity between 4 studies when the vertebral artery hypoplasia was defined by vertebral artery?2 mm in diameter(I~2=0.0%,P=0.985),a fixed effects model was used.The result showed that the vertebral artery hypoplasia rate was significant difference[OR=2.29,95%CI(1.82,2.88)].We used the fixed effect model and random effect model to pool the OR,when the vertebral artery hypoplasia was defined by vertebral artery?2.5mm in diameter(I~2=43.5%,P=0.151).The results of fixed effect model[OR=2.34,95%CI(1.82,3.02)]and random effect model[OR=2.42,95%CI(1.70,3.43)]showed that there was significant difference in the incidence of vertebral artery hypoplasia.No individual study significantly influenced the pooled ORs in the sensitivity analysis.No publication bias was detected by Begg's or Egger's test.ConclusionVertebral artery hypoplasia is closely related to the posterior circulation infarction and it may increase the risk of posterior circulation infarction.