{
  "abstract": "Background: Recurrence, recanalization, reperfusion, or retreatment remains an important durability limitation after endovascular treatment of intracranial aneurysms. Most recurrence studies characterize blood pressure exposure as a history or study-defined diagnosis of hypertension rather than achieved post-treatment systolic or diastolic blood pressure.\n\nObjective: To quantify the association between study-defined/history-based hypertension status and recurrence-related outcomes after endovascular aneurysm treatment, and to separately summarize indirect clinical evidence on achieved blood pressure, blood pressure variability, and mechanistic hemodynamic evidence.\n\nMethods: PubMed/MEDLINE, Ovid MEDLINE, and Embase were searched from database inception through April 2026. The direct recurrence synthesis included adult endovascular aneurysm cohorts reporting recurrence-related outcomes according to hypertension status. Indirect clinical studies of achieved blood pressure or blood pressure variability and mechanistic computational-fluid-dynamics studies were synthesized separately. Odds ratios (ORs) for the direct recurrence analysis were pooled using inverse-variance random-effects models with restricted maximum-likelihood estimation and Hartung-Knapp adjustment. Study selection was independently performed by two reviewers at title/abstract and full-text stages; unresolved disagreements were adjudicated by a third reviewer.\n\nResults: Thirty-one studies were included. Eight studies provided extractable 2 × 2 data for the primary recurrence-related analysis (2,442 observations: 1,231 in the hypertension/high-BP-status group and 1,211 in the non-hypertension group; 559 recurrence-related events overall, 242 and 317 respectively). Study-defined hypertension showed a directionally higher but statistically non-significant association with recurrence/recanalization/reperfusion (OR 1.36, 95% CI 0.92–2.00; p = 0.104; I ² = 31.4%). No eligible recurrence study reported recurrence according to achieved SBP/DBP target categories. The overlapping full and matched Lee 2021 controlled-versus-uncontrolled hypertension estimates were presented separately and were not pooled. BP-variability studies addressed heterogeneous clinical outcomes and were not quantitatively pooled.\n\nConclusion: Current evidence is insufficient to establish study-defined hypertension as an independent predictor of recurrence after endovascular aneurysm treatment or to recommend a recurrence-preventive blood pressure target. The available direct evidence concerns predominantly history-based hypertension status, whereas achieved blood pressure and blood pressure variability evidence is indirect for angiographic recurrence.",
  "abstract_shown": true,
  "affiliations": [
    "Jiangyin Clinical College, Xuzhou Medical University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Weiyuan Pan"
    },
    {
      "affs": [
        0
      ],
      "name": "Yu Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Heng Gao"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bww5dabty9ffg.bib",
  "cited_by": 0,
  "doi": "10.3389/fneur.2026.1928054",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fneur.2026.1928054/full",
  "id": "bww5dabty9ffg",
  "issns": [
    "1664-2295"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fneur.2026.1928054/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC346-429"
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    [
      "openalex",
      "2728|Intracranial Aneurysms: Treatment and Complications"
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  "openalex": "W7223652873",
  "pdf_url": "https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2026.1928054/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-26",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/bww5dabty9ffg.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:16Z",
      "native_id": "10.3389/fneur.2026.1928054",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fneur.2026.1928054/full"
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    {
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Intracranial Aneurysms: Treatment and Complications",
      "subfield": "neurology"
    }
  ],
  "title": "Blood pressure status and recurrence risk after endovascular treatment of intracranial aneurysms: a systematic review and meta-analysis with narrative synthesis of blood pressure targets and hemodynamic evidence",
  "title_text": "Blood pressure status and recurrence risk after endovascular treatment of intracranial aneurysms: a systematic review and meta-analysis with narrative synthesis of blood pressure targets and hemodynamic evidence",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:47:35Z",
  "url": "https://research.draconitic.com/paper/bww5dabty9ffg",
  "venue": "Frontiers in Neurology",
  "versions": []
}