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There is no consensus for the optimal treatment strategy (conservative vs. surgical vs. various endovascular approaches). We aim to present a\u00a0multicenter experience of BAPA treatment using flow-diverter (FD) stents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>At five tertiary neurovascular centers, all cases of ruptured BAPAs treated by FD were retrospectively collected. Baseline imaging and clinical characteristics, complications, as well as early and long-term angiographic and clinical outcome (mRS) were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighteen patients (mean age, 57\u00a0years; SD, \u00b110.7\u00a0years) with acute SAH related to a\u00a0BAPA were treated using 18\u00a0FD stents. Aneurysms were detected on initial imaging study in 28%; delayed diagnosis was triggered by clinical deterioration due to rebleeding in 15%. No rebleeding after FD was seen, 28% developed FD-related ischemic complications. At long term (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u200916), overall mortality was 13% (2\/16), and favorable outcome (mRS 0\u20132) was 81% (13\/16). All BAPAs (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u200913) were completely occluded at long-term angiographic follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In our multicenter experience, FD treatment of ruptured BAPAs appears to have comparable safety and efficacy outcomes to FD treatment of other ruptured posterior circulation aneurysms as well as to the conservative management of BAPAs. This treatment strategy for a\u00a0ruptured BAPA achieved a\u00a0high rate of angiographic occlusion and favorable clinical outcome; however, as the conservative management also seems to offer similar clinical outcomes an individualized treatment decision is warranted. Future prospective studies comparing both approaches are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00062-021-01133-y","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T14:03:36Z","timestamp":1642687416000},"page":"783-789","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Flow Diverter Treatment of Ruptured Basilar Artery Perforator Aneurysms"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3796-5709","authenticated-orcid":false,"given":"Samer","family":"Elsheikh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"M\u00f6hlenbruch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Seker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansgar","family":"Berlis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naci","family":"Kocer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ala","family":"Jamous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Behme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Taschner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Urbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Meckel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,20]]},"reference":[{"key":"1133_CR1","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1136\/neurintsurg-2019-015311","volume":"12","author":"MF Granja","year":"2020","unstructured":"Granja\u00a0MF, Monteiro\u00a0A, Agnoletto\u00a0GJ, Jamal\u00a0S, Sauvageau\u00a0E, Aghaebrahim\u00a0A, Hanel\u00a0R. 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A.\u00a0Berlis: financial interests: Stryker, Microvention, Medtronic, Sequent Medical (Proctor and service-related fees), phenox (lecture honorary, CEC), and Penumbra (lecture honorary). Nonfinancial interests: none. M.\u00a0M\u00f6hlenbruch: financial interests: consultancy: Medtronic, MicroVention, Stryker Neurovascular, phenox*; grants\/grants pending: Balt, MicroVention*; payment for lectures including service on speakers bureaus: Medtronic, MicroVention, Stryker Neurovascular. Nonfinancial interests: none. S.\u00a0Elsheikh: financial interests: research grants from Bracco Suisse S.A., Medtronic, Cerenovus. Travel grant from Medtronic. Nonfinancial interests: none. S.\u00a0Meckel: financial interests: consultant to Acandis GmbH, Microvention, Stryker, and Novartis Pharma GmbH, speaker fees (modest)\/travel grant from Medtronic. Nonfinancial interests: none.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Due to the retrospective nature of this study, approval of the ethics committee was not obtained. All interventions in this study were clinically indicated. The decision was made in each participating center. Conception of the study and data collection were retrospective.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}