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Ruptured and unruptured aneurysms are less common in younger individuals compared to older patients. Endovascular treatment has gained popularity over surgical options in the general population, but surgery remains the primary treatment for younger patients due to concerns about higher recurrence rates with endovascular procedures. This study compared the immediate and long-term outcomes of endovascular treatment in patients under 40 years with those aged 41-60. The study included 239 patients who underwent endovascular treatment for intracranial aneurysms, divided into two age groups: under 40 and 41-60 years. The rates of immediate radiologic outcomes, complications, and recurrence were assessed. The results showed successful aneurysm obliteration rates of 70.1% in the younger group and 64.0% in the older group. The complication rates were 1.5% in the younger group and 3.5% in the older group, with the older group experiencing more procedure-related complications, though this difference was not statistically significant. Long-term follow-up revealed recurrence rates of 23.2% in the younger group and 18.2% in the older group, with no significant difference. The study suggests that endovascular treatment is as effective and safe for patients under 40 years. Therefore, it may be considered an acceptable first-line treatment for younger patients, aligning its use with that in older populations.
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http://dx.doi.org/10.3390/jcm13164764 | DOI Listing |
Interv Neuroradiol
September 2025
Department of Neuroradiology, Walton Centre for Neurology and Neurosurgery, Liverpool, UK.
ObjectiveThis study aims to determine the outcomes of nickel allergic patients who underwent a trial of forearm arterial stenting with a nickel-based stent, with follow-up to assess for an allergic reaction. In the absence of adverse effects, patients had their intracranial aneurysm treatment with a nickel-based cerebrovascular device.MethodsA retrospective analysis was performed on patients who had an allergy to nickel, with an intracranial aneurysm who underwent treatment with a permanently implanted nickel-containing device.
View Article and Find Full Text PDFNeurosurg Rev
September 2025
Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany.
Purpose: To share our clinical experience with conservative management of isolated spinal arterial aneurysms (ISAs) and to identify clinical scenarios where conservative management may be appropriate, in the context of a literature review.
Methods: We performed a retrospective review of spinal angiograms from two German neuroradiology centers and conducted a systematic literature review of reported ISA cases. We analyzed demographics, clinical presentation, imaging findings, treatments, and outcomes.
Neurosurg Rev
September 2025
Department of Neurology, Radiology & Neurosurgery, University of Iowa Hospitals and Clinics, Iowa, IA, USA.
The role of intravenous thrombolysis (IVT) in patients with tandem lesions (TL) undergoing endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) remains a subject of ongoing debate. The substantial clot burden and the potential need for periprocedural antiplatelet therapy during emergent carotid stenting (CAS) add to the complexity of treatment decisions. This study aims to systematically review and meta-analyze the literature to evaluate the comparative safety and efficacy of IVT plus EVT versus EVT alone in AIS patients with TL.
View Article and Find Full Text PDFInterv Neuroradiol
September 2025
Department of Neuroradiology, Queen's Hospital, Greater London, UK.
The Nautilus intrasaccular system (EndoStream Medical, Israel) is a spiral-shaped neck-bridging endovascular device designed to support coiling of intracranial aneurysms [1-3]. It is deployed into the aneurysm sac through a 0.0165" or 0.
View Article and Find Full Text PDFJ Neurosurg Anesthesiol
September 2025
Anesthesiology, University of Michigan, Ann Arbor, MI.
Background: Carotid blowout syndrome (CBS) is a life-threatening emergency involving the rupture of the carotid arteries and/or branches, often following surgery and radiotherapy for head and neck cancer. Our case series aimed to describe airway management strategies, endovascular and surgical approaches, perioperative resuscitation management, and clinical outcomes in a cohort of patients with CBS at a tertiary referral academic health center.
Methods: We retrospectively identified patients presenting with CBS between 2017 and 2021.