Surgical clipping of a recurrent small saccular aneurysm after repeated coil embolization.
A 59-year-old healthy woman presented with sudden onset of severe headache. Computed tomography and digital subtraction angiography (DSA) demonstrated subarachnoid hemorrhage (grade I according to the Hunt and Hess classification) due to a ruptured small right posterior cerebral artery (PCA) aneurysm. The ruptured PCA aneurysm was completely embolized with three Guglielmi detachable coils (GDCs). However, follow-up DSA 3 months after the initial coiling confirmed refilling of the aneurysm. The aneurysm was successfully re-embolized with two GDCs. Follow-up DSA 10 months later revealed regrowth of the aneurysm. Surgical clipping was performed without compromising the parent vessels. Long-term angiographic follow up is necessary even in patients with small saccular aneurysms which are apparently completely embolized by endovascular coil treatment.
Yoshida
Kazumichi
K
Department of Neurosurgery, Kurashiki Central Hospital. ky7694@kchnet.or.jp
Wataya
Takafumi
T
Hojo
Masato
M
Doi
Daisuke
D
Yamagata
Sen
S
D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012008:Recurrence; D019233:Retreatment; D014656:Vascular Surgical Procedures