Abstract Number: Esoc2026ot56 Prognostic Factors for Recurrent Ischemic Events After Cervical Artery Dissection: Asystematic Review of Observational Cohort Studies

Abstract Background and aims: Methods Systematically identify prognostic factors associated with recurrent ischemic events after cervical artery dissection. Results A comprehensive systematic search of PubMed, Scopus, Cochrane Library, and Web of Science was conducted through December 2025. Inclusion criteria were Studies reporting recurrence definitions, baseline characteristics, and follow-up data. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool across six domains. Heterogeneity was quantified with I2. Event rates in recurrent versus non-recurrent groups were extracted, and relative risks (RRs) with 95% confidence intervals (CIs) were summarized when available. Conclusions Study included four retrospective cohort studies (n = 18000) published between 1995 and 2025. Definitions of recurrence varied but consistently included new or worsening ischemic neurological events confirmed clinically and/or radiologically. Follow-up duration ranged from 3 to 31 months. Overall risk of bias was low to moderate. Factors significantly associated with recurrent ischemic events included anterior circulation occlusion (RR 3.30, 95% CI 2.48–4.40), cervical artery occlusion (RR 1.59, 95% CI 1.17–2.17), intracranial embolism (RR 2.75, 95% CI 1.26–6.03), poor Circle of Willis (RR 1.96, 95% CI 1.33–2.89), intracranial large-vessel occlusion (RR 1.44, 95% CI 1.19–1.75), prior ischemic stroke (RR 1.77, 95% CI 1.08–2.90), and coronary artery disease (RR 1.63, 95% CI 1.28–2.06). In contrast, a.fib, trauma, pseudoaneurysm, TIA at presentation, and absence of antithrombotic therapy were not consistently associated with recurrence. Conflict of interest