Endovascular treatment for remnant or recurrence of intracerebral aneurysms after clipping

Aim. An aneurysm remnant or recurrence has the potential risk of rupture; therefore, additional treatment is recommended. However, repeated clipping surgery might be difficult due to preexisting clips and postoperative tissue adhesion. Methods. Between 2004 and 2013, we encountered 4 patients Faith previously clipped aneurysms which were embolized with platinum coils. TWO patients with aneurysms at the internal carotid artery and posterior communicating artery (IC-Co. bifurcation showed subarachnoid hemorrhage from the recur ring aneurysms: a ruptured aneurysm clipped 20 years ago and an unruptured aneurysm clipped ET years ago. In the latter patient, the exravasation of contrast medium and coil dislodgement from the aneurysm occurred during the procedure. In the other 2 patients, the residual aneurysiris of IC-PCoA and the anterior communicating artery (AComA) aneurysms after clip ping were treated within a short postoperative period. One of them suffered from intracerebral hemorrhage in the right frontal lobe adjacent to the clip. Results. In all patients, the aneurysms were successfully embolized with platinum coils. During the procedures, in 2 patients with IC-PeoA and AComA aneurysms, the working le had to be changed step by step. Conclusion. Endovascular treatment using platinum coils is effective technique for patients with residual or recurring an after clipping. However, preexisting clips may be ob stacles to visualizing the aneurY sm and parent artery during catheterization and coil filling. In such cases, the working angle should be changed in any step to visualize the aneurysm neck and parent artery.