Certain high risk unruptured intracranial aneurysms (IA) are not amenable to preventive treatment by coiling or clipping. We reviewed current evidence on efficacy and safety of a minimally invasive alternative treatment: the endovascular embolisation of the IA using flow diverters.

Five prospective uncontrolled studies were evaluated. There is moderate evidence for efficacy using the angiographic surrogate parameter aneurysm occlusion in a large percentage of treated aneurysms. The current evidence is, however, not sufficient to prove, that the assessed technology of endovascular embolisation with flow diverters is more effective and safe with regards to clinical outcomes than no treatment, endovascular coiling or surgical clipping.

At present, we recommend against the inclusion of flow diverters in the Austrian BMG catalogue of procedures and suggest a re-evaluation in 2017.