Purpose of review: In the last decade, there has been a rapid development in new endovascular treatment options for cerebral aneurysms. These techniques have their own inherent risk and can be challenging for the attending anesthetist.
Recent findings: The recent developments of stent-assisted aneurysm coiling, flow-diverting stents and gel embolization, have implications for the attending anesthesiologist and the patient. These developments allow embolization of more complex aneurysms, but require anticoagulation with its inherent risks.
Summary: The different endovascular techniques relevant to the anesthetist, the anesthetic options and complications that can occur during endovascular treatment of these patients will be discussed. This article can be a guidance to the anesthesiologist attending endovascular procedures for cerebral aneurysms.