Paraclinoid aneurysms: is there a new endovascular standard?

Objectives: Paraclinoid aneurysms are challenging lesions to treat with traditional surgical and conventional endovascular techniques despite modern improvements in technique and technology. Flow diversion emerged recently as a promising new therapy that overcomes limitations related to the wide-neck and fusiform morphology, and importantly addresses the underlying diseased parent artery from which the aneurysm arises. Methods: We reviewed the current literature regarding the safety and efficacy of flow diversion therapy for treatment of paraclinoid aneurysms. Results: Early results suggest excellent ability for flow diversion to remodel the diseased parent artery and achieve durable complete angiographic occlusion of the aneurysm with acceptable rates of periprocedural risk. Discussion: Flow diversion therapy can achieve durable and high rates of obliteration that surpass traditional methods of management for paraclinoid aneurysms. However, caution is warranted when considering this treatment modality due to several concerning and often-unpredictable complications associated with this technology.