RT Journal Article SR Electronic T1 Failure of aneurysm occlusion by flow diverter: a role for surgical bypass and parent artery occlusion JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP e13 OP e13 DO 10.1136/neurintsurg-2013-011062 VO 7 IS 4 A1 Thomas Mattingly A1 Brian Van Adel A1 Erin Dyer A1 Pablo Lopez-Ojeda A1 David M Pelz A1 Stephen P Lownie A1 Thomas Marotta A1 Melfort Boulton YR 2015 UL http://jnis.bmj.com/content/7/4/e13.abstract AB Flow diverters represent a paradigm shift in the treatment of aneurysms. However, unusual and poorly understood complications are being reported. We present a case of a giant internal carotid artery terminus aneurysm treated with flow diversion that progressively and symptomatically enlarged despite a reduction in the filling portion. Complete occlusion of the aneurysm and reduction in mass effect occurred through superficial temporal artery– middle cerebral artery bypass and parent artery occlusion. Incomplete aneurysm occlusion following flow diversion has been reported, but mechanisms and predisposing factors are speculative and definitive solutions have not been described. This case illustrates a potential solution.