Early Regrowth and Recanalization of Ruptured Large Aneurysm after Guglielmi Detachable Coil Treatment: Report of Two Cases

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We present two cases of ruptured large aneurysms that present regrowth and recanalization after Guglielmi detachable coil (GDC) treatment.<BR>The first patient, a 72-year-old woman, presented with subarachnoid hemorrhage (SAH) secondary to rupture of a 10-mm left internal carotid artery aneurysm with a 5-mm neck. The first GDC embolization was performed at 9 hours after onset, leaving contrast filling of the dome from the distal neck. Follow-up angiography 3 months later revealed aneurysmal regrowth, recanalization and coil compaction. A second embolization was performed, resulting in complete occlusion. However, follow-up angiography 9 months later revealed recanalization again. A third coiling was performed, resulting in complete occlusion. The second patient, a 53-year-old man, presented with SAH secondary to rupture of a 20-mm anterior communicating artery aneurysm with an 8-mm neck. GDC embolization was performed at 3 hours after onset, leaving a residual portion of the aneurysm neck. Ten months later, follow-up angiography demonstrated aneurysmal regrowth, recanalization and coil compaction. Repeat coiling was performed, resulting in residual neck filling. Both patients have lived normal daily lives without rebleedings.<BR>Because the large aneurysms with wide neck coiled with GDC have a tendency to regrowth and recanalize, close postoperative angiographic and clinical monitoring of patients with such aneurysms is necessary. If follow-up angiograms show coil compaction inside the aneurysm with re-exposure of portion of the aneurysm to the blood flow, further GDC treatment and/or a surgical approach should be considered.

Early Regrowth and Recanalization of Ruptured Large Aneurysm after Guglielmi Detachable Coil Treatment: Report of Two Cases

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