Transcranial clipping of recurrent cerebral aneurysms after endovascular treatment.

BACKGROUND AND PURPOSE Treatment of intracranial aneurysms by interventional neurovascular techniques may be useful as a therapeutic alternative. We describe two cases of recurrent aneurysms after endovascular treatment using detachable balloons. CASE DESCRIPTION Two cases are reported of recurrence 2 years after endovascular treatment of cerebral aneurysms (posterior communicating in both cases). One patient had a subarachnoid hemorrhage after rupture of a posterior communicating aneurysm. The other patient had an aneurysm diagnosed incidentally after a contrast-enhanced computed tomographic scan of the head for an unrelated problem. Endovascular balloon embolization of both aneurysms was performed without any immediate complication. Two years after treatment, a cerebral angiogram showed recurrent aneurysms. Surgical clipping excluded both aneurysms definitely. CONCLUSIONS These cases highlight the importance of control angiography at long-term follow-up and emphasize the significance of balloon migration after endovascular treatment of aneurysms.