LAUSR

The authors describe in the article “Microsurgical and endovascular treatment of un-ruptured cerebral aneurysms by European hybrid Neurosurgeons to balance surgical skills and medical staff Management” the experience of the socalled hybrid neurosurgeons, i.e., performing both open microvascular and endovascular operations (EVT), in the treatment of unruptured aneurysms. They find both their open surgical and endovascular results comparable to those published in the literature and argue for more such hybrid neurosurgeons to perform endovascular aneurysm treatments in Europe. I do not think that this article should be read as a comparison between techniques; there are clearly an inclusion bias, e.g., more MCA-aneurysms were treated with microsurgery whereas large and giant aneurysms were treated endovascularly, and if you claim to be equally good as somebody else, you should compare yourself with someone doing the same procedure, i.e., the literature, not with yourself doing another type of procedure. Instead, this article highlights alternative ways to organize the treatment of intracranial aneurysms, while I, having a neurosurgical background myself, sympathize with many of the statements made in the article, I think some points remain for discussion.