Based on one of the broadest experiences available, the paper reviews and analyses developments and outcomes in endovascular and microsurgical treatments of a very demanding class of cerebrovascular lesions. Using regression analysis, the researchers look at the outcomes and factors that influence them. They found no indication that the Stanford Medical Center’s treatment of posterior circulation fusiform aneurysms is effective.Treatment is complicated by perforator arteries, the absence of an aneurysm distinct neck, and the often-extensive nature of posterior circulation fusiform aneurysms. The authors wanted to assess these treatments in a long-term series at their neurovascular referral centre because there have been advancements in microsurgical and endovascular methods, including flow diversion.

They examined independent and dependent variables such as presenting features, aneurysm location and size, and surgical strategy using regression approaches. At a mean 14-month follow-up, the authors discovered moderate impairment or better (mRS score 3) in 85 percent of the patients. Flow diversion patients had higher problems, although the difference was not statistically significant in regression models.Fusiform aneurysms of the posterior circulation are a difficult aneurysm subtype to cure, but with a multidisciplinary treatment strategy, good results can be achieved. Traditional endovascular and microsurgical procedures continue to be successful options, even though flow diversion is a welcome addition to the armamentarium.

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