Journal of cerebrovascular and endovascular neurosurgery最新文献

{"title":"Incidental meningiomas discovered during intracranial aneurysm clipping: The importance of intraoperative dural biopsy.","authors":"Kahyen Ko, Gi Yeop Lee, Yong Hun Song, Sang Hyo Lee, Tae Won Choi, Si Un Lee, Jae Seung Bang, Bong-Gyu Ryu","doi":"10.7461/jcen.2026.E2025.12.005","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2025.12.005","url":null,"abstract":"<p><p>The coexistence of an intracranial aneurysm (IA) and meningioma (MNG) is a rare clinical entity (0.13-1.17%). However, the prevalence of clinically occult MNGs may be underestimated, as routine vascular imaging often misses small lesions. We present two female patients with a history of multiple or recurrent IAs and prior endovascular treatment. During surgical clipping via a pterional approach, suspicious dural lesions-hypervascularization and thickening around the anterior clinoid process-were incidentally identified, despite being invisible on preoperative imaging. Intraoperative biopsies confirmed these lesions as MNGs. While the exact pathogenesis or underlying association remains speculative, these cases highlight the critical importance of unexpected intraoperative findings. Neurosurgeons must maintain high vigilance and strongly consider active biopsy of abnormal dura mater encountered during IA clipping, particularly in patients with multiple IAs or previous endovascular treatments.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noncardiogenic pulmonary edema triggered by acetazolamide, a rare complication of acetazolamide challenge test.","authors":"Seung Jin Lee, Seungnam Son, Jiha Kim","doi":"10.7461/jcen.2026.E2026.01.002","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.01.002","url":null,"abstract":"<p><p>The acetazolamide challenge test is frequently performed to evaluate cerebral blood flow and reserve capacity in cerebrovascular disease. Most of its side effects are mild and transient. Acute pulmonary edema (PE) has never been reported to occur after acetazolamide challenge tests. Here, we present a case of acute noncardiogenic PE triggered by an acetazolamide challenge test. A 62-year-old man with carotid artery stenosis underwent an acetazolamide challenge test during an arterial spin labeling (ASL) magnetic resonance (MR) imaging study. The patient showed stable vital signs and no neurologic abnormalities. The patient had no pulmonary or cardiac problems that could induce acute PE. Routine laboratory findings, electrocardiography, and chest X-ray also produced normal findings. An acetazolamide challenge ASL MR study was performed with intravenous administration of 1 g of acetazolamide. Two hours after acetazolamide administration, sudden dyspnea and hypoxemia developed, and chest X-ray and computed tomography revealed diffuse PE. Immediately, the oxygen supply and furosemide treatment were initiated. The following day, the dyspnea and PE improved and the patient recovered completely. To the best of our knowledge, this is the first case report of acute noncardiogenic PE triggered by intravenous acetazolamide administration in an acetazolamide challenge test.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical management of ruptured intracranial aneurysms in sickle cell disease patients.","authors":"Ahmet Hamit Çınkı, Mehmet Özer","doi":"10.7461/jcen.2026.E2026.03.005","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.03.005","url":null,"abstract":"<p><strong>Objective: </strong>Sickle cell disease (SCD) is a hereditary hemoglobinopathy associated with various cerebrovascular complications. Although ischemic stroke is the most common manifestation, subarachnoid hemorrhage (SAH) secondary to ruptured intracranial aneurysms represents a rare but life-threatening condition in this population. Data regarding the optimal management of aneurysmal SAH in SCD patients remain limited.</p><p><strong>Methods: </strong>We retrospectively analyzed eight patients with confirmed SCD who were diagnosed with aneurysmal SAH and treated at a tertiary referral center. Clinical severity was assessed using the Glasgow Coma Scale (GCS), World Federation of Neurosurgical Societies (WFNS) grade, Hunt-Hess grade, and Fisher score. Aneurysm characteristics, including size, location, and multiplicity, were recorded. All patients underwent endovascular coil embolization. Hematologic parameters and peri-procedural multidisciplinary management strategies were reviewed. Aneurysm occlusion status was evaluated using the Raymond-Roy Occlusion Classification (RROC) at 6-month follow-up.</p><p><strong>Results: </strong>A total of 11 aneurysms were identified in 8 patients (mean age: 34.5 years; 5 males, 3 females). Three patients (37.5%) had multiple aneurysms. Six aneurysms (54.5%) were located in the anterior circulation and five (45.5%) in the posterior circulation. Four patients (50%) developed clinical and radiological vasospasm requiring intra-arterial therapy. All aneurysms were successfully treated with endovascular coiling. At discharge, modified Rankin Scale (mRS) scores ranged from 0 to 6. At 6-month follow-up, complete occlusion (RROC Class I) was achieved in the majority of treated aneurysms. Multidisciplinary perioperative management, including hematology consultation and transfusion strategies, was applied in all cases.</p><p><strong>Conclusions: </strong>Ruptured intracranial aneurysms in patients with SCD require careful multidisciplinary management due to disease-specific hematologic and vascular risks. Endovascular coil embolization appears to be a safe and effective treatment modality in this population. Early aneurysm securing combined with optimized hematologic management may improve clinical outcomes and reduce procedure-related complications.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angular morphometric factors associated with intraoperative rupture in anterior communicating artery aneurysms: A prospective observational study.","authors":"Vemula Venkata Ramesh Chandra, Sree Datta Pradeep Kundum, Kanduri Prithvi, Bodagala Vijayalakshmi Devi, Yangannagari Praveen, Bodapati Chandra Mowliswara Prasad, Thota Silpa, Aparna Rajeshwar Bitla","doi":"10.7461/jcen.2026.E2026.02.002","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.02.002","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between angular morphometric parameters of anterior communicating artery (AComA) aneurysms and intraoperative rupture, and to assess the relationship of inflammatory biomarkers (high-sensitivity C-reactive protein (hs-CRP), homocysteine) with aneurysm wall inflammation.</p><p><strong>Methods: </strong>In this prospective observational study, 37 patients with AComA aneurysms undergoing microsurgical clipping (Jan 2023-Dec 2025) were included. All presented with aneurysmal subarachnoid hemorrhage (Fisher Grade ≥1). Morphometric parameters-aneurysm size, aspect ratio, size ratio, height-width ratio, vessel angle, flow angle, parent vessel angle, and inclination angle-were measured using computed tomography (CT) angiography and intraoperative microscopy. Aneurysm inflammation was defined by macroscopic features (wall thickening, discoloration, adhesions, friability). Preoperative hs-CRP and homocysteine levels were recorded. Patients were categorized into intraoperative rupture (n=13) and unruptured (n=24) groups. Statistical analysis used SPSS v26.0 (p≤0.05).</p><p><strong>Results: </strong>Vessel angle (74.76±15.9 vs. 56.8±25.8; p=0.03) and flow angle (153.24±15.3 vs. 137.58±22.4; p=0.035) were significantly higher in ruptured cases. Parent vessel angle was higher in unruptured aneurysms (121.88±33.4 vs. 98.85±10.2; p=0.02). hs-CRP (68.86±57.3 vs. 30.86±49.8; p=0.032) and homocysteine (12.47±5.2 vs. 9.38±3.4; p=0.041) were elevated in inflamed aneurysms but showed no association with intraoperative rupture.</p><p><strong>Conclusions: </strong>Vessel, flow, and parent vessel angles are significantly associated with intraoperative rupture risk. While hs-CRP and homocysteine reflect aneurysm inflammation, they do not predict intraoperative rupture. CT Angiography (CTA)-based morphometric parameters may assist in surgical risk stratification.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid cavernous fistula in Sturge-Weber syndrome: A unique case and literature review of associated vascular malformations.","authors":"Hector R Martinez, Emiliano Barajas de Leon, Alfonso Jose Castillo-Ivon, Paola Itzel Velediaz-Duran, Daniela Ayala-Victoria, Jose Alberto Moran-Guerrero, Nerea Martin Del Campo, Guillermo K Pons-Monnier, Jose Antonio Infante-Cantu, Beatriz Perez-Martinez, Oscar Gutierrez-Trevino, Sofia Lucila Rodriguez-Rivera, Jose A Figueroa-Sanchez","doi":"10.7461/jcen.2026.E2025.11.004","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2025.11.004","url":null,"abstract":"<p><p>Sturge-Weber syndrome (SWS) is a neurocutaneous disorder associated with various intracranial abnormalities, such as leptomeningeal angiomatosis, the characteristic facial port wine stain (PWS), among others. However, several non-classic ones, such as non-traumatic carotid cavernous fistulas (CCF), represent not only life-threatening but commonly unrecognized abnormalities, posing a significant risk to these patients.</p><p><strong>Objective: </strong>We present a comprehensive analysis of current literature to describe vascular anomalies associated with SWS and present a case of a CCF in a patient with SWS.</p><p><strong>Methods: </strong>A case with an unusual concurrent finding of CCF and SWS is presented following CARE guidelines. Additionally, we conducted a literature review using MEDLINE, Scopus, and Web of Science databases focusing exclusively on vascular anomalies associated with SWS.</p><p><strong>Results: </strong>Our review identified 243 cases describing vascular anomalies in patients with SWS, with a minor number of cases describing a cavernous sinus anomaly.</p><p><strong>Conclusions: </strong>The co-occurrence of SWS and CCF appears to be underreported. Although SWS is associated with multiple vascular anomalies, current evidence supports a predisposing vascular environment rather than a direct causal relationship with CCF. Although other vascular anomalies are significantly associated with SWS, there is still a research gap with ample area of opportunity to define their clinical impact and the most appropriate management.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative ultrasound for localization of a ruptured M2-M3 middle cerebral artery aneurysm with temporal hematoma: A case report.","authors":"Taigen Sase, Kiyotaka Wakatsuki, Gaku Hidaka, Homare Nakamura, Hidetoshi Murata","doi":"10.7461/jcen.2026.E2025.10.009","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2025.10.009","url":null,"abstract":"<p><p>We present a patient who had a ruptured distal middle cerebral artery (MCA) aneurysm at the M2-M3 junction with a temporal lobe hematoma, in which intraoperative ultrasound (iUS) proved critical for real-time aneurysm localization when neuronavigation was compromised by brain shift. An elderly patient with subarachnoid hemorrhage and a large temporal lobe intracerebral hematoma underwent craniotomy, hematoma evacuation, and aneurysm clipping. Preoperative computed tomography angiography (CTA) identified a 5-mm aneurysm at the left M2-M3 junction. During surgery, neuronavigation was initially planned but deemed unreliable after hematoma removal due to brain shift. Instead, iUS was used through the cortical surface to localize the aneurysm and parent vessels in real-time. iUS successfully visualized the aneurysmal sac and inflow vessel within the evacuated hematoma cavity. This allowed the surgical team to safely expose the parent vessel, identify the aneurysm neck, and clip the aneurysm without complications. Postoperative imaging confirmed complete hematoma evacuation and aneurysm obliteration. In patients with deep-seated ruptured distal MCA aneurysm accompanied by intracerebral hematoma, iUS can be a valuable real-time tool for localization when neuronavigation is unreliable, thereby improving surgical precision and safety.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safety and efficacy of anti-thrombotic agents during mechanical thrombectomy procedure for acute ischemic stroke: A systematic review and meta-analysis.","authors":"Luh Ari Devanita S, I Gede Raka Adhyatma, I Putu Ananta Wijaya Sabudi, Luh Nyoman Ari Trisnasanti","doi":"10.7461/jcen.2026.E2025.11.006","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2025.11.006","url":null,"abstract":"<p><strong>Objective: </strong>Ischemic stroke, primarily driven by large-vessel atherosclerosis, is frequently treated with mechanical thrombectomy (MT). While anti-thrombotic agents during MT procedure are commonly used, their risk-benefit profile remains unclear. This study compares the safety and efficacy of anti-thrombotic administration in acute ischemic stroke patients undergoing MT.</p><p><strong>Methods: </strong>We systematically searched PubMed, ScienceDirect, and Google Scholar for studies evaluating anti-thrombotic use during MT. Data were analyzed using Review Manager (Web Version). We calculated odds ratios (OR) with 95% confidence intervals (CI) for safety outcomes (sICH and 3- to 6-month mortality) and efficacy outcomes (successful recanalization and functional independence).</p><p><strong>Results: </strong>Thirteen observational studies (n=4,923) were included. Anti-thrombotic use did not significantly alter the risk of sICH [OR 0.83 (95% CI 0.63-1.1); p=0.21; I2=25%]. However, it was associated with reduced 3-6-month mortality [OR 0.57 (95% CI 0.33-0.99); p=0.05; I2=86%], though heterogeneity was high. Regarding efficacy, anti-thrombotic use showed no significant association with successful recanalization [OR 1.22 (95% CI 0.81-1.83); p=0.63; I2=74%] or functional independence [OR 1.07 (95% CI 0.81-1.41); p=0.31; I2=73%].</p><p><strong>Conclusions: </strong>Administration of anti-thrombotic agents during MT may reduce 3- to 6-month mortality without increasing sICH risk. However, they do not appear to significantly improve recanalization rates or functional independence. Given the high heterogeneity in mortality data, these results should be interpreted with caution.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tenzingplasty for symptomatic, non-occlusive intracranial atherosclerotic disease after maximal medical therapy failure.","authors":"Faraz Behzadi, Cameron M McDougall, Neehar Gaddam, Judy Dawod, Ekokobe Fonkem, Andrei V Alexandrov, Nikhil K Mehta","doi":"10.7461/jcen.2026.E2025.11.003","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2025.11.003","url":null,"abstract":"<p><strong>Objective: </strong>Intracranial atherosclerotic disease (ICAD) is an important cause of ischemic stroke. Balloon angioplasty for ICAD with or without a stent is associated with a high complication rate. The Tenzing support catheter (Route92 Medical) is a tapering offset catheter designed for improving aspiration catheter delivery in large vessel occlusion ischemic stroke (LVO). In LVO secondary to ICAD, we noted that the Tenzing could be used for angioplasty. In this study, we report our experience with the Tenzing angioplasty technique (T-Plasty) for ICAD treatment in the absence of LVO.</p><p><strong>Methods: </strong>A prospectively maintained database of all adult ICAD patients without LVO treated with T-Plasty at our institution was reviewed. Information on demographics, procedural details, clinical outcomes, and complications is reported here based on the National Institute of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). Student's T-test was applied to evaluate for statistical significance when appropriate.</p><p><strong>Results: </strong>From September 2024 to April 2025, 18 adult patients underwent T-Plasty for symptomatic ICAD without LVO. All patients experienced an improvement; the early cohort had a 4.5 points reduction in NIHSS immediate post T-Plasty, and both the elective and early cohorts experienced close to 1 point improvement in baseline mRS. No operative or post-operative related complications were noted up to 30-day follow-up.</p><p><strong>Conclusions: </strong>T-Plasty for the elective treatment of chronic symptomatic ICAD and acute hypoperfusion syndrome is an option for improving neurologic outcome.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgical treatment of saccular basilar artery trunk aneurysms: Results and case illustrations.","authors":"Revaz Dzhindzhikhadze, Vadim Gadzhiagaev, Andrey Polyakov, Ruslan Sultanov, Abdulla Abdullaev, Andrey Zaytsev","doi":"10.7461/jcen.2025.E2025.03.005","DOIUrl":"10.7461/jcen.2025.E2025.03.005","url":null,"abstract":"<p><strong>Objective: </strong>Saccular aneurysms of the basilar artery (BA) trunk are a significant challenge in neurosurgery due to their rarity and the complexity of surgical approaches. This study examines the efficacy and outcomes of microsurgical treatment for these aneurysms, highlighting the advantages over endovascular methods in terms of occlusion rates and complication management.</p><p><strong>Methods: </strong>A retrospective review of 23 patients with BA trunk aneurysms treated microsurgically at the Moscow Regional Clinical Research Institute from June 2019 to April 2024 was conducted. Patient demographics, aneurysm characteristics, surgical techniques, and postoperative outcomes were analyzed.</p><p><strong>Results: </strong>The study group included 16 women and 7 men, with an average age of 51.2 years. Notably, 19 of 23 patients (82.6%) presented with subarachnoid hemorrhage (SAH), while 4 had unruptured aneurysms (2 asymptomatic, 2 with mass effect). Aneurysms were predominantly located at the origin of the superior cerebellar artery (SCA). Surgical approaches varied based on aneurysm location, with most utilizing the orbito-pterional approach. Complete occlusion was achieved in all cases and was maintained over the follow-up period without signs of recanalization. Complications included transient oculomotor nerve dysfunction in 5 patients, with a substantial recovery rate. Favorable outcomes (mRS 0-2) were achieved in 87% of patients, including most SAH cases, highlighting the safety and effectiveness of treatment.</p><p><strong>Conclusions: </strong>Microsurgical treatment of BA trunk aneurysms provides a reliable occlusion with a low rate of complications and excellent clinical outcomes. This series supports microsurgery as a preferred option for managing these challenging aneurysms, particularly when located at the SCA origin.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"10-23"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-overlapping Y-stent configuration flow diverter placement in a complex anterior cerebral artery bifurcation aneurysm.","authors":"Megan Finnerann, Ajeet Gordhan","doi":"10.7461/jcen.2025.E2025.05.006","DOIUrl":"10.7461/jcen.2025.E2025.05.006","url":null,"abstract":"<p><p>Y-configuration stent deployment strategies for aneurysms with complex configurationare well recognized, with and without subsequent coil placement. Delivery of flow diverters in this configuration has no precedent in the literature and may be a viable alternative when feasible. A case is presented in which this configuration for a complex anterior cerebral artery aneurysm was achieved, with subsequent successful aneurysm closure.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"70-76"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}