Response: successful endovascular treatment of three fusiform cerebral aneurysms with the pipeline embolization device in a patient with dilating HIV vasculopathy. Authors reply

We read with great interest the letter from Dr Bruno Law-Ye Jr et al1 commenting on our recent article on the use of flow diversion for treatment of three de novo fusiform aneurysms due to dilating HIV vasculopathy in an adult patient.2

As clearly stated in our manuscript, although this entity is most commonly seen in children, the natural history of adult patients who present with fusiform cerebral aneurysms due to dilating HIV vasculopathy is poorly understood. Indeed, a thorough literature review by our group, before presenting possible treatments to our patient, disclosed only 20 published cases in the English literature. Among these published cases, the clinical outcomes were dismal, as discussed in our manuscript.

As we state, although flow diversion offers a good option for endovascular treatment of this rare type of aneurysm, it should not be viewed as first-line therapy. Nevertheless, one should...

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