Journal of cerebrovascular and endovascular neurosurgery最新文献

{"title":"Delayed angiographic detection of a ruptured basilar artery perforator aneurysm in diffuse initially angiographically occult subarachnoid hemorrhage: A case report and literature review.","authors":"Bae Jae Kim, Hyun-Gon Kim, Gyojun Hwang, Jae Seong Kang, Sung Han Oh, Jong-Hyeok Park","doi":"10.7461/jcen.2026.E2026.07.006","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.07.006","url":null,"abstract":"<p><p>Basilar artery perforator aneurysms (BAPAs) are uncommon and may remain occult on initial angiography because of their minute size and dynamic morphology. A 69-year-old man presented with sudden severe headache and mild drowsiness (Glasgow Coma Scale 14, World Federation of Neurosurgical Societies grade II). Computed tomography showed diffuse subarachnoid hemorrhage involving the basal cisterns and sylvian fissures with fourth ventricular intraventricular hemorrhage. Initial digital subtraction angiography (DSA) revealed no bleeding source. Although repeat DSA is generally performed approximately 1 week later at our institution, the diffuse and asymmetric aneurysmal-type hemorrhage pattern prompted earlier repeat DSA on hospital day 4. This demonstrated an approximately 1.7-mm fusiform-appearing aneurysm arising from a right basilar artery perforator just below the superior cerebellar artery. High-resolution vessel wall magnetic resonance imaging (MRI) and cone-beam computed tomography (CT) angiography were not performed. Conservative management was selected because of the minute distal perforator lesion and procedural risk. The patient was discharged on day 21 with a modified Rankin Scale score of 1, which remained unchanged at 3 months. This case emphasizes the importance of timely repeat DSA and consideration of adjunctive high-resolution imaging in diffuse initially DSA-negative subarachnoid hemorrhage.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185987","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":"Combined endovascular and surgical management of scalp cirsoid aneurysms: A case series from Northeast India.","authors":"Gorky Medhi, Shreya Ashtosh Raina, Ashim Kumar Boro, Basanta Kumar Baishya","doi":"10.7461/jcen.2026.E2026.04.003","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.04.003","url":null,"abstract":"<p><strong>Objective: </strong>Cirsoid aneurysms are rare, high-flow extracranial arteriovenous malformations of the scalp characterized by complex vascular anatomy and significant arteriovenous shunting. Owing to their rarity, optimal management strategies remain poorly defined. This study aims to describe the clinical presentation and evaluate outcomes following a combined endovascular and surgical approach.</p><p><strong>Methods: </strong>This retrospective consecutive case series included all patients treated for scalp cirsoid aneurysms between October 2022 and December 2023 at a tertiary neurosurgical center. All patients underwent detailed radiological evaluation, including computed tomography angiography and digital subtraction angiography (DSA). Demographic characteristics, clinical features, treatment details, and outcomes were analyzed.</p><p><strong>Results: </strong>Six patients (4 males, 2 females) with a mean age of 23.5 years (range: 18-30 years) were included. All presented with painless pulsatile scalp swelling. DSA demonstrated high-flow lesions supplied by branches of the external carotid artery, most commonly the superficial temporal artery, without intracranial communication. All patients underwent preoperative embolization using Onyx™ 18 (Medtronic, Minneapolis, MN, USA), followed by complete surgical excision within 24-48 hours. Complete obliteration was achieved in all cases, with no perioperative complications. No residual arteriovenous shunting or recurrence was observed during follow-up.</p><p><strong>Conclusions: </strong>In this small retrospective series, preoperative Onyx embolization followed by surgical excision was associated with complete lesion obliteration, favorable clinical outcomes, and absence of recurrence during follow-up. Larger studies are required to confirm long-term efficacy and durability.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187229","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":"Architecture-guided reconstructive decision-making for large and giant intracranial aneurysms: A 42-case strategy-oriented series.","authors":"Toshiyuki Tsuboi, Masaki Sunaga, Hideo Ohba, Yuko Miyazaki, Yosuke Kajihara, Shigeyuki Sakamoto, Shinji Ohba, Kazutoshi Mukada","doi":"10.7461/jcen.2026.E2026.06.006","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.06.006","url":null,"abstract":"<p><strong>Objective: </strong>To describe an architecture-guided reconstructive decision-making framework for large and giant intracranial aneurysms and to illustrate its clinical applicability using a consecutive institutional series.</p><p><strong>Methods: </strong>We retrospectively reviewed 42 consecutive patients harboring 42 large or giant intracranial aneurysms treated between January 2017 and July 2025. Lesions were classified according to lesion architecture and reconstructive controllability. Clinical outcomes, angiographic aneurysm exclusion, and procedure-related complications were analyzed.</p><p><strong>Results: </strong>Thirty-one aneurysms (73.8%) were classified as non-terminal type and 11 (26.2%) as terminal type. Flow diversion was primarily applied to non-terminal aneurysms, whereas terminal aneurysms were preferentially treated by microsurgical reconstruction. Favorable clinical outcomes (modified Rankin Scale [mRS] 0-2) were achieved in all patients treated with flow diversion and in 95.5% of those treated microsurgically. Complete aneurysm exclusion was confirmed at follow-up angiographic evaluation in all cases, including O'Kelly-Marotta (OKM) grade D at the predefined 1-year angiographic endpoint in all endovascularly treated aneurysms. Terminal aneurysms frequently incorporated branch origins, limiting complete aneurysm exclusion by flow diversion alone because preservation of branch patency necessitated persistent flow across the bifurcation. Among the 42 aneurysms, 39 (92.9%) were classified as large aneurysms (10-24 mm) and 3 (7.1%) as giant aneurysms (≥25 mm).</p><p><strong>Conclusions: </strong>Treatment selection for large and giant intracranial aneurysms may be guided by lesion architecture through the assessment of reconstructive controllability rather than morphology alone. The proposed framework provides a modality-neutral approach for integrating microsurgical and endovascular reconstructive strategies according to the anatomical characteristics of individual lesions.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187307","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":"Individualized left transradial access for flow-diverter treatment in a patient with coexisting aberrant right subclavian and brachioradial arteries: A technical case report.","authors":"Gaku Hidaka, Taigen Sase, Kiyotaka Wakatsuki, Homare Nakamura, Hidemichi Ito, Hidetoshi Murata","doi":"10.7461/jcen.2026.E2026.05.004","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.05.004","url":null,"abstract":"<p><p>Transradial approach (TRA) has been widely adopted in neuroendovascular procedures because of its lower incidence rates of access-site complications and improved patient comfort. However, anatomical variations of the upper extremity arteries and aortic arch can significantly affect catheter stability and procedural feasibility. We report a technical note describing the treatment of a cerebral aneurysm in a 38-year-old woman with concomitant aberrant right subclavian artery (ARSA) and right brachioradial artery (BRA). Diagnostic cerebral angiography performed through the right upper extremity revealed difficulty with selective catheterization of the anterior circulation due to these vascular anomalies. Based on these findings, left TRA was selected. Preprocedural assessment, including left upper extremity angiography, confirmed the feasibility of this approach. A flow-diverter stent was successfully deployed for a left internal carotid artery paraclinoid aneurysm using a Simmons-type guiding system through left transradial access, without procedural instability or major complications. In patients with multiple upper extremity arterial variations, including ARSA and BRA anomalies, right TRA may be technically challenging. Careful preprocedural evaluation of vascular anatomy and flexible selection of the access route are critical. Left TRA may serve as a safe and effective alternative when right-sided anatomical variants compromise catheter stability.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883005","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":"Postoperative posterior MCA territory infarction following single-barrel STA-MCA bypass with hemodynamic territory mismatch in moyamoya disease: A case report.","authors":"Min-Seok Woo, Myungsoo Kim","doi":"10.7461/jcen.2026.E2026.06.007","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.06.007","url":null,"abstract":"<p><p>The success of superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass in moyamoya disease (MMD) depends not only on anastomotic patency but on whether the revascularized territory corresponds to the most hemodynamically compromised region. We report a case of postoperative posterior MCA territorial infarction attributable to hemodynamic territory mismatch. A 47-year-old woman with bilateral MMD presented with progressive left hemiparesis. Preoperative computed tomography (CT) perfusion demonstrated markedly reduced cerebral blood flow (CBF) and diffuse mean transit time (MTT) prolongation, most pronounced in the right posterior MCA and posterior cerebral artery (PCA) territory. Digital subtraction angiography (DSA) identified prominent choroidal periventricular anastomosis (ChA-PA) as a marker of deep perforator territory hemodynamic stress. She underwent right single-barrel STA-MCA bypass using the frontal STA branch anastomosed to a temporal M4 branch, combined with encephalo-duro-arterio-synangiosis (EDAS). Despite confirmed patency on intraoperative indocyanine green (ICG) videoangiography, she developed acute infarction in the right posterior MCA territory on postoperative day 1 - the region not covered by the temporal anastomosis. Two-month follow-up DSA demonstrated bypass patency and regression of ChA-PA. This case highlights the importance of preoperative perfusion-guided bypass planning to avoid hemodynamic territory mismatch. In patients with posterior MCA territory compromise, anastomosis should target the most ischemic region, or double-barrel bypass should be considered.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883060","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":"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":"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":"312-315"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847953","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":"Preoperative ipsilateral thalamic volume reduction as a prognostic marker in malignant middle cerebral artery infarction undergoing decompressive craniectomy.","authors":"Teck Cheng Yap, Ramani Thiagarajah, Johari Yap Abdullah, Mohd Sofan Zenian, Song Yee Ang, Ab Rahman Izaini Ghani, Zamzuri Idris, Jafri Malin Abdullah","doi":"10.7461/jcen.2026.E2025.09.005","DOIUrl":"10.7461/jcen.2026.E2025.09.005","url":null,"abstract":"<p><strong>Objective: </strong>Malignant middle cerebral artery infarction is associated with high mortality and severe disability despite decompressive craniectomy. The thalamus plays a central role in arousal and sensorimotor integration and may be vulnerable to early compression from cerebral mass effect. This study evaluates whether preoperative ipsilateral thalamic volume reduction predicts functional outcomes following decompressive craniectomy.</p><p><strong>Methods: </strong>This retrospective cohort study included 41 adult patients with malignant middle cerebral artery infarction who underwent decompressive craniectomy between April 2017 and September 2022. Preoperative computed tomography scans were analysed for infarct volume, midline shift, herniation markers, and percentage ipsilateral thalamic volume reduction. Functional outcomes were assessed at discharge and 90 days using the Full Outline of UnResponsiveness score, National Institutes of Health Stroke Scale, modified Rankin Scale, Barthel Index, and Disability Rating Scale. Logistic regression and receiver operating characteristic analyses were performed.</p><p><strong>Results: </strong>Mean ipsilateral thalamic volume reduction was 15.1%. Each 1% increase in thalamic volume loss independently increased the odds of poor functional outcome, defined as modified Rankin Scale scores of 5-6, at discharge and 90 days. Greater thalamic distortion was associated with higher National Institutes of Health Stroke Scale scores. Receiver operating characteristic analysis demonstrated good discrimination, with optimal thresholds of 14% at discharge and 19% at 90 days. Increased thalamic compression was associated with postoperative infections and longer hospital stays.</p><p><strong>Conclusions: </strong>Preoperative ipsilateral thalamic volume reduction is a strong imaging biomarker for predicting outcomes after decompressive craniectomy in malignant middle cerebral artery infarction.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"255-278"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114902","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":"Hemorrhagic transformation following a malignant middle cerebral artery infarction.","authors":"Salah Sehweil, Zoya Goncharova, Prashanth Nataraj, Manvi Khandelwal","doi":"10.7461/jcen.2026.E2025.05.001","DOIUrl":"10.7461/jcen.2026.E2025.05.001","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the frequency of hemorrhagic transformation (HT) and evaluate its impact on the clinical course and outcomes of patients with malignant middle cerebral artery (MCA) infarction.</p><p><strong>Methods: </strong>A retrospective review was conducted of 74 patients with malignant MCA infarction, aged 44 to 92 years (mean age 71.5±2.0 years; 54.0% female), admitted between 2017 and 2025. Conservative therapy was administered to 77.0% of patients, while 22.9% underwent decompressive hemicraniectomy. All cases of HT were assessed using computed tomography according to the ECASS I classification.</p><p><strong>Results: </strong>In the study cohort, 15% of patients received intravenous thrombolysis (IVT). Significantly, among this group, 100% developed HT as a complication. Hemorrhagic infarction (HI) occurred in 81.8% of these cases and was asymptomatic, not worsening the clinical condition or neurological deficits. Parenchymal hemorrhage (PH) occurred in 18.2% and was associated with clinical deterioration and fatal outcomes. In patients not receiving IVT, HT was observed in 66.6% of cases: HI type 1 occurred in 33.3%, HI type 2 in 47.6%, and PH type 1 in 19.0%. No cases of PH type 2 were reported.</p><p><strong>Conclusions: </strong>HT is highly prevalent in malignant MCA infarction, regardless of IVT administration, with the majority of cases asymptomatic. Consequently, these findings suggest that asymptomatic HT may represent a natural progression of large infarcts rather than a treatment complication. The results underscore the need for early diagnostic markers and improved management strategies for HT in malignant MCA infarction.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"226-234"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004872","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":"Hybrid treatment for cerebellar arteriovenous malformations: A preliminary descriptive study.","authors":"Óscar Medina-Carrillo, Julio César López-Valdés, Arturo Ayala-Arcipreste, Rafael Mendizabal-Guerra, Julio César Soto-Barraza, Gustavo Melo-Guzmán","doi":"10.7461/jcen.2026.E2025.09.006","DOIUrl":"10.7461/jcen.2026.E2025.09.006","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of preoperative embolization on intraoperative blood loss and surgical duration in patients undergoing cerebellar intracranial arteriovenous malformation (AVM) resection (2011-2022).</p><p><strong>Methods: </strong>A descriptive, retrospective, preliminary study (n=10 with complete data) classified patients into a Hybrid group (embolization+surgery, n=8) and a Surgery-only group (n=2). Intergroup comparisons for surgical metrics used the Mann-Whitney U test.</p><p><strong>Results: </strong>The Hybrid group demonstrated significantly improved intraoperative metrics. This cohort showed a highly significant decrease in blood loss (437.14 cc vs. 3,400 cc; p=0.018) and a significant reduction in surgical time (325 minutes vs. 530 minutes; p=0.018). Functionally, the Hybrid group achieved excellent recovery (median modified Rankin Scale [mRS] 1 at 6 months) despite having worse baseline morbidity (median mRS 3 vs. 1.5). The study found no significant difference in mRS improvement between groups.</p><p><strong>Conclusions: </strong>Preoperative embolization is associated with reduced blood loss and shorter surgical duration in cerebellar AVM resection. These findings support embolization as a valuable adjunctive therapy. The results provide strong preliminary evidence of efficacy and intraoperative safety, but validation in prospective studies with larger samples is required.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"235-246"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286801","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":"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":"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":"217"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517947","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}