Among patients with HTPR who underwent stent-assisted coil embolization for an unruptured intracranial aneurysm, there was no significant difference between the TAT and MDAT groups regarding the risk of all bleeding events and thromboembolic events during the 90 days of follow-up.

The safety and efficacy of coronavirus disease 2019 (COVID-19) vaccination in patients diagnosed with Moyamoya disease (MMD) have not been established. Using National Health Insurance Service data, this study analyzed the occurrence of stroke-related events and mortality following COVID-19 vaccination among patients diagnosed with MMD from 2008 to 2020. Among 10,297 MMD patients, 296 (2.9%) experienced events and 175 (1.7%) died in 2021. Significant risk factors for events included ages 50-59 (Odds Ratio [OR] 3.29; P = 0.022) and 60 or above (OR 5.20; P = 0.001) (reference group: age in 20s), low BMI (OR 2.00; P = 0.011), previous stroke (OR 1.96; P < 0.001), and COVID-19 infection (OR 2.28; P = 0.034). Female (OR 0.64 [95% CI 0.50-0.82]; p = 0.011), revascularization surgery (RS) (OR 0.38 [95% CI 0.21-0.70]; p < 0.001), and vaccination (OR 0.17 [95% CI 0.13-0.22]; p < 0.001) were associated with reduced odds of stroke-related events. For mortality, significant risks were age over 60 (OR 7.09; P = 0.008), low BMI (OR 3.87; P = 0.001), and prior stroke (OR 1.74; p = 0.004), while being female, RS (OR 0.41; P = 0.022), and vaccination (OR 0.12; P < 0.001) were associated with a lower frequency of mortality. mRNA vaccines were associated with a significantly lower incidence of events, mortality, and COVID-19 infections compared to vector vaccines. COVID-19 vaccination is linked to reduced stroke-related events and mortality in MMD patients, with mRNA vaccines showing a significantly lower incidence compared to vector vaccines. COVID-19 infection raises the risk of events, underscoring the benefit of vaccination.

Among patients with HTPR who underwent stent-assisted coil embolization for an unruptured intracranial aneurysm, there was no significant difference between the TAT and MDAT groups regarding the risk of all bleeding events and thromboembolic events during the 90 days of follow-up.

The safety and efficacy of coronavirus disease 2019 (COVID-19) vaccination in patients diagnosed with Moyamoya disease (MMD) have not been established. Using National Health Insurance Service data, this study analyzed the occurrence of stroke-related events and mortality following COVID-19 vaccination among patients diagnosed with MMD from 2008 to 2020. Among 10,297 MMD patients, 296 (2.9%) experienced events and 175 (1.7%) died in 2021. Significant risk factors for events included ages 50-59 (Odds Ratio [OR] 3.29; P = 0.022) and 60 or above (OR 5.20; P = 0.001) (reference group: age in 20s), low BMI (OR 2.00; P = 0.011), previous stroke (OR 1.96; P < 0.001), and COVID-19 infection (OR 2.28; P = 0.034). Female (OR 0.64 [95% CI 0.50-0.82]; p = 0.011), revascularization surgery (RS) (OR 0.38 [95% CI 0.21-0.70]; p < 0.001), and vaccination (OR 0.17 [95% CI 0.13-0.22]; p < 0.001) were associated with reduced odds of stroke-related events. For mortality, significant risks were age over 60 (OR 7.09; P = 0.008), low BMI (OR 3.87; P = 0.001), and prior stroke (OR 1.74; p = 0.004), while being female, RS (OR 0.41; P = 0.022), and vaccination (OR 0.12; P < 0.001) were associated with a lower frequency of mortality. mRNA vaccines were associated with a significantly lower incidence of events, mortality, and COVID-19 infections compared to vector vaccines. COVID-19 vaccination is linked to reduced stroke-related events and mortality in MMD patients, with mRNA vaccines showing a significantly lower incidence compared to vector vaccines. COVID-19 infection raises the risk of events, underscoring the benefit of vaccination.

High PRU (≥220) and low IR (≤14.5%) are related to ISR R3 following CAS, which may cause ipsilateral ischemic stroke.

To reduce the recurrence of cerebral aneurysms, second-generation hydrogel embolic coils (HECs) have been developed. We aimed to compare the impacts of bare platinum coils (BPCs) and HECs on the recurrence of ruptured intracranial aneurysms (RIAs). In this study, participants with an RIA were randomly assigned to the BPC or HEC group at a 1:1 ratio. The primary outcome was any recurrence during the 12-month follow-up period. The secondary outcomes included retreatment, procedural complications, delayed cerebral ischemia, favorable clinical outcomes (modified Rankin Scale score ≤ 2), ventriculoperitoneal shunt operation, and the coil’s ease of manipulation. After excluding 11 patients, 57 patients were ultimately included for analysis (BPC, n = 26; HEC, n = 31). The primary outcome was not statistically significant between 2 groups (BPC group: 10/26 [38.5%]; HEC group: 6/31 [19.4%]; P = 0.144). The secondary outcomes did not differ between the 2 groups, except for the coil’s ease of manipulation (P = 0.007). Multivariate analysis revealed no significant difference between the two groups in terms of the primary outcome (rate of recurrence [OR = 0.46; 95% CI, 0.13–1.61; P = 0.223]) or in terms of the secondary outcomes, including retreatment (OR = 0.77; 95% CI, 0.12-5.00; P = 0.766), favorable clinical outcomes (OR = 1.05; 95% CI, 0.16–6.90; P = 0.957), or VP shunt operation (OR = 0.11; 95% CI, 0.01–1.54; P = 0.102). Among patients who underwent coil embolization for an RIA, there were no significant differences between the two groups in terms of the rates of recurrence, retreatment, favorable clinical outcomes or VP shunt operation during the 12-month follow-up period. Given the small sample size, these results should be interpreted with caution. This study is a registered clinical trial. It was prospectively registered in the ClinicalTrials.gov (NCT04988503) on July 23, 2021.

This study shows that the level of interobserver agreement was very high for treatment versus no-treatment decisions, but moderate regarding the strength of the recommendations. Further studies are needed to clarify the detailed reasons for the similarities and differences in clinicians' recommendations.

Objectives: To evaluate our preliminary surgical outcome of extradural skull base lesions requiring sacrifice of ICA.