Einar Bogason

Endovascular embolization by parent artery reconstruction of a symptomatic fusiform posterior cerebral artery aneurysm using Onyx HD-500: a neurointerventional report.

Posterior cerebral artery aneurysms are treatment challenge for the neurosurgeon. Parent artery occlusion, trapping and bypass have been the classic treatment options for aneurysms in this location. With the introduction of newer embolic agents such as Onyx®, endovascular intervention is now a viable therapy for these aneurysms.

Intracranial Stenting Gets a Revisit but Outcomes Still Favor Medical Management

population ended up including 1710 patients. Themedian follow-up was 4.2 years, and the length of follow-up did not differ between the 2 treatment branches. The authors reported 52 fatal or disabling strokes in the stenting group versus 49 in the endarterectomy group. There was no significant statistical difference in the 5-year cumulative risk of these incidences between the stenting group and the endarterectomy group (6.4% vs. 6.5%, hazard ratio [HR] 1.06, 95% confidence interval [CI] [0.72e1.57], P1⁄4 0.77). However, the rate of any stroke was more prevalent in the stenting group compared with the endarterectomy group (119 vs. 71, ITT population, 5-year cumulative risk 15.2% vs. 9.4%, HR 1.71, 95% CI [1.28e2.30], P < 0.001; per-protocol population, 5-year cumulative risk 8.9% vs. 5.8%, 1.53, 1.02e2.31, P 1⁄4 0.04) (Table 1). The majority of these strokes were nondisabling. Long-term rates of severe carotid restenosis did not differ between the 2 treatment modalities. Furthermore, there was no significant statistical difference in the modifiedRankin scale scores at 1 year, 5 years, or thefinal follow-up.