We read with interest the recent publication by Caroff et al1 on saccular MCA aneurysm treatment by flow diverters (FDs), in regard to the increasing tendency to use FDs in distal, off-label localizations. We appreciate their important contribution to the subject but remain reserved regarding their strong conclusion. The subject is still under research, but some promising clinical and angiographic outcomes have been published.2 We were slightly perplexed by the interpretation of the reported complication rate, taking into account the methodologic limitations of the study due to the small number of subjects.
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