Endovascular coil embolization of residual or recurrent aneurysms after surgical clipping

Purpose: Treatment of residual or recurrent aneurysms after surgical clippi ng is a challenge and most surgeons prefer to avoid a second surgical attem pt. We present treatment of 4 residual or recurrent aneurysms after surgica l clipping with electrolytically detachable coils. Material and Methods: In 3 of 4 patients, recurrent aneurysms were diagnose d with angiography 2 months, 5 years and 14 years after surgery, although t he domes of the aneurysms were opened following clipping during the surgery . In the 4th patient, an early postoperative angiogram revealed filling of a residual aneurysm secondary to the incomplete neck clipping. Guglielmi de tachable coils were used to occlude the residual or recurrent aneurysm. Results: The endovascular approach was successful in all patients and the c ontrol angiograms showed complete obliteration of the aneurysms with no rec analization. Conclusion: The endovascular approach is a good treatment option for patien ts in whom complete obliteration of the aneurysm cannot be achieved by surg ical clipping. Opening of the aneurysm sac after clipping does not necessar ily preclude aneurysm regrowth from a neck remnant proximal to the clip.