For neuroendovascular surgeons treating intracranial aneurysms, two of the most difficult to treat are bifurcation aneurysms arising at the basilar apex or the carotid terminus.  Until recently, effective techniques that could be applied with acceptable risk were available only outside the U.S.  In June 2014, the U.S. Food and Drug Administration (USFDA) approved an investigational device exemption for the PulseRider® (Pulsar Vascular, San Jose, CA), a reconstruction device intended for wide-neck aneurysms at or near a bifurcation of the basilar tip or carotid terminus.  The first three U.S. cases were done by Alejandro M. Spiotta, M.D., Assistant Professor in the Department of Neurosciences, Raymond D. Turner, M.D., Associate Professor in the Department of Neurosciences, and M. Imran Chaudry, M.D., Associate Professor of Radiology at the Medical University of South Carolina (MUSC). They were able to achieve complete occlusion of the aneurysm without intraprocedural complications in all three cases. These cases are part of a multicenter clinical trial currently being conducted at eight select centers in the U.S. The trial is ongoing and patient enrollment is scheduled to end in late fall 2015. Dr. Spiotta and co-authors reported on these results in the January 5, 2015 issue of the Journal of Neurointerventional Surgery