Figure 4: Aneurysm regrowth treated with repeat GDC packing. Upper left, initial angiogram demonstrates an unusual basilar tip aneurysm with a narrow elongated neck. In retrospect, this may have been a small aneurysm with formation of an adjacent pseudoaneurysm as a result of rupture. Upper right, immediate post-treatment angiogram demonstrates tight coil packing of the large, distal aneurysm component. Attempted coil placement into the small neck remnant resulted in herniation of coil loops into the upper basilar artery. Lower left, six-month follow-up angiogram demonstrates coil compaction and migration, with interval aneurysm recurrence. Lower right, angiogram demonstrating result of second GDC treatment. A neck remnant is present, smaller than after the initial procedure. Angiography will be repeated in six months.

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