{
  "abstract": "Introduction Ruptured posterior inferior cerebellar artery (PICA) aneurysms are rare, anatomically complex, and associated with high morbidity. Both microsurgical clipping and endovascular treatment (EVT) are viable options; however, comparative evidence remains limited, and the optimal treatment strategy is still debated.Materials and Methods We retrospectively analyzed 36 patients with ruptured PICA aneurysms treated at two institutions (clipping 11, EVT 25). Treatment assignment was based on the definitive modality in crossover cases. To adjust for baseline differences, propensity score–based methods were applied, including inverse probability of treatment weighting (IPTW) with stabilized weights and truncation, as well as 1:1 propensity score matching as a sensitivity analysis. Outcomes were evaluated using Firth’s penalized logistic regression for binary variables and distributional analysis of the modified Rankin Scale (mRS) using the Wilcoxon rank-sum test.Results Significant baseline imbalances, particularly in sex and WFNS grade, were partially corrected after IPTW. EVT was consistently associated with significantly lower rates of traction injury and cranial nerve palsy across multiple analytic approaches. Overall complication rates were also lower with EVT in IPTW analysis. Functional outcomes assessed by mRS distribution demonstrated a significant shift toward better outcomes in the EVT group at 1-year and last follow-up, indicating improved neurological recovery over time ( table 1). Angiographic outcomes, including complete occlusion, PICA patency, and retreatment rates, were comparable between groups.Conclusion EVT is associated with fewer procedure-related complications and significantly better mid- to long-term functional outcomes based on mRS distribution compared with clipping. These findings suggest EVT as a favorable treatment strategy for ruptured PICA aneurysms.Disclosures J. Lee: None. I. Shin: None.Abstract E-059 Table 1Patient demographics, presentations, aneurysm characteristics and clinical outcomes",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, Hallym University Gangdong Sacred Heart Hospital, Seoul, Korea, Republic of"
      ],
      "name": "J Lee"
    },
    {
      "affiliations": [
        "Neurosurgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do, Korea, Republic of"
      ],
      "name": "I Shin"
    }
  ],
  "title": "E-059 Surgical versus endovascular management of ruptured posterior inferior cerebellar artery aneurysms: a bi-institutional propensity score-weighed analysis",
  "uid": "0caae7d4-a269-5622-8583-76bfd557ad5a"
}