Treatment with a pipeline embolization device (PED) is widely accepted as an excellent option for patients harboring giant, wide neck, saccular intracranial aneurysms. It has been shown to be safe and very effective. We describe a previously unreported case of a large middle cerebral artery aneurysm, related to the carotid tip, that was treated with a PED and coils. The 6 month follow-up angiogram demonstrated complete occlusion of the aneurysm. However, the 9 month angiogram revealed recurrent filling of the aneurysm sac. To our knowledge, this is the first report to describe recanalization of an aneurysm totally occluded on the control angiography after treatment with a PED. Unanswered questions include the mechanism of recanalization and the need for additional control angiograms and MRI following a previous examination revealing total aneurysm occlusion.
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Contributors FPT helped to conceive the study, and drafted and approved the manuscript. ACU helped to conceive the study and the study design, helped with revision of the manuscript, and gave final approval of the manuscript. MTR and LHC-A participated in data acquisition, editing of the figures, revision of the manuscript, and final approval of the manuscript. DGA conceived the study, revised the manuscript critically, and approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The ethics committee and review board of the institutions approved the study.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Not applicable.