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Endovascular treatment is a less invasive therapy for treating cerebral aneurysms. Various new devices manufactured by medical companies have greatly helped to further improve and develop this treatment. Also, simple and similar procedures enable a short learning curve for physicians. Endo‒saccular coiling is indicated for most aneurysms except for fusiform, giant or partially thrombosed aneurysms. Stents are used for wide‒neck aneurysms, and achieve less recanalization with more ischemic complications. Parent artery occlusion is still the standard treatment for fusiform, giant, partially thrombosed aneurysms if it is feasible. The balloon occlusion test is useful to determine the indication for bypass surgery prior to parent artery occlusion. The flow diverter stent is a newly developed device to facilitate the gradual thrombosis of the aneurysm and neointimal remodeling of the aneurysmal neck, and enable us to cure large/giant lateral type aneurysms of the proximal internal carotid artery. It will be indicated for unruptured cavernous and paraclinoid large/giant aneurysms in Japan. (Received August 25, 2015;accepted September 14, 2015)

Tactics and Procedures of Endovascular Treatment of Cerebral Aneurysms