• Alejandro M Spiotta, Mithun G Sattur, Peter Kan, and R Webster Crowley.
• Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA. Electronic address: spiotta@musc.edu.
• World Neurosurg. 2020 Oct 1; 142: 339-351.

BackgroundEndovascular therapy is a viable alternative to surgical clipping for the treatment of intracranial aneurysms; however, aneurysms arising at bifurcations remain a challenge. The purpose of this technical report is to share the nuances of treating aneurysms with the PulseRider (PR), including device selection and positioning strategy, from authors who are highly experienced in its use.MethodsWe offer a comprehensive guide for neuroendovascular surgeons less experienced with PR applications to include design, general coil embolization technique, principles of deployment and detachment, positioning options, and geometric challenges and their solutions.ResultsIn our experience, the PR is well suited for addressing the challenges of treating bifurcation aneurysms.ConclusionsPR use is intuitive and straightforward for use in bifurcation aneurysms with ideal favorable. PR can also be safely and effectively used to address a much broader and more challenging range of geometries.Copyright © 2020 Elsevier Inc. All rights reserved.

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