Introduction Neuro-interventional models are often used to develop, test, and compare devices, in addition to advancing the understanding of pathophysiology. Device interaction, flow dynamics, and technique evaluations greatly depend on accurate modeling of the vessel diameters, which may be impacted by ethnic variations. This systematic review and meta-analysis attempts to determine if there vessel size differences exist between the European and Chinese populations.

Methods A systematic review of the literature in the PubMed database was performed to identify studies reporting vessel diameters obtained through validated imaging on European and Chinese populations free of major comorbidities from Jan 2020 until Jul 2022. All Circle of Willis vessels were studied, and a minimum of 5 articles per vessel were needed to perform a meta-analysis using a random-effects model. Analyses were performed using RStudio (2022.07.2+576), and results were reported as means (in mm) with 95% CI pooled random-effects estimates.

Results A total of 595 studies were screened, 54 were included overall, and 28 studies could be included in the quantitative synthesis after restricting to studies that met the pre-specified study selection criteria. Vessels of interest with at least 5 articles were the middle cerebral artery (MCA) M1 segment, basilar artery (BA), and vertebral artery (VA). The MCA M1 diameter for the European population (2.37mm [95% CI: 2.26 - 2.49]) was not different from the Chinese population (2.60mm [2.32 - 2.93]) (p=0.149, I² = 99.2%). The BA diameter for the European population (2.92 [2.49 - 3.43]) was smaller compared to the Chinese population (3.66 [95% CI: 3.27 - 3.99]) (p=0.014, I² = 98.2%). Lastly, the VA diameter for the European population (2.87 mm [95% CI: 2.57 - 3.20]) was similar to the Chinese population (2.67mm [95% CI: 2.32 - 3.07]) (p=0.427, I² = 98.3%).

Conclusions In this meta-analysis, the MCA M1 and VA diameters were found to be similar for European and Chinese populations, while the BA was smaller in the European population. This suggests most models are already capturing ethnic variations in vessel size.

Disclosures M. Mirza: 5; C; Cerenovus. S. Lascalza: 5; C; Cerenovus. J. Wang: 5; C; Cerenovus. K. Kummer: 5; C; Superior Medical Experts. P. Brouwer: 5; C; Cerenovus.