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Surgical clipping of a recurrent small saccular aneurysm after repeated coil embolization

Kazumichi Yoshida1, Takafumi Wataya, Masato Hojo

  • 1Department of Neurosurgery, Kurashiki Central Hospital. ky7694@kchnet.or.jp

Neurologia Medico-Chirurgica
|July 26, 2005
PubMed

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.

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