A 21-year-old patient came to our attention on suspicion of recurrence of a right internal carotid artery aneurysm previously treated endovascularly in another centre with stent and coils placement. The patient also had a history of previous occlusion of the ipsilateral middle cerebral artery with development of Moya-Moya-like collateralization. The preliminary angiographic study confirms the revascularization of the aneurysmal sac and also demonstrates the fracture of the previously placed stent. We then proceed to endovascular treatment by re-navigating the stent and placing multiple flow-diverting stents in a telescopic manner.

We also bring a companion case of another patient treated endovascularly in our centre for an internal carotid artery aneurysm with associated ipsilateral middle cerebral artery occlusion and development of Moyamoya-like syndrome.

Disclosure of Interest nothing to disclose