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Background Despite the current availability of flow diverter devices (FDD),problems remains regarding optimal endovascular treatment (EVT) for blood blister-like aneurysms (BBAs) of the inteal carotid artery (ICA).Objective To evaluate the safety and efficacy of EVT of BBAs in the ICA with a Willis covered stent.Methods 20 consecutive patients (5 men and 15 women) with ruptured BBAs underwent EVT using a Willis covered stent in two institutions from March 2013 to March 2018.Clinical observations,angiographic characteristics,and procedural and follow-up outcomes were retrospectively evaluated.Results 20 consecutive patients (5 men and 15 women) with ruptured BBAs underwent EVT using a Willis covered stent in two institutions from March 2013 to March 2018.Clinical observations,angiographic characteristics,and procedural and follow-up outcomes were retrospectively evaluated.Conclusion Our initial results demonstrate that reconstructive EVT using a Willis covered stent provides a viable approach to treat ICA BBAs.However,an expanded clinical evaluation and larger cohort are needed to confirm the results.