Over the last decade, there have been significant improvements of the endovascular techniques and the development of a wide range of devices including 3-D coils, spherical coils, and complex coils. The introduction of balloon and stent remodeling techniques resulted in further expansion of the devices and techniques available to neurointerventionalists, and made EVT possible for greater percentage of patients. Enhancement of platinum coil thrombogenicity has been attempted by surface modifications using Dacron® fibers, bioabsorbable polymers (Cerecyte® coil, Codman/Micrus Endovascular; Matrix®coil, Boston Scientific) or hydrogel coatings (HydroCoil®, MicroVention). The use of non adhesive embolic agents such as Onyx® (ev3) for aneurysm embolization has proven to be an occlusive method that, in some patients, completely fills and conforms to the unique geometry of the aneurysm cavity, resulting in complete aneurysm obliteration. A relatively new technique being used is Parent Vessel Reconstruction using stents (Neuroform® microstent Boston Scientific, Enterprise™ Codman®, Pipeline Embolization Device, Covidien) not just to coil the aneurysm but to change the parent vessel configuration, redirect the flow of blood to help reduce the wall shear stress on the aneurysm and to promote tissue growth over the neck of the aneurysm.