الفهرس 
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Abstract
Summary
Aneurysm treatment is dedicated to prevention of rupture (for unruptured aneurysms) or rebleeding (for ruptured aneurysms). Endovascular embolization has become the first-line of treatment for intracranial aneurysms in the majority of cases in many institutions. This minimally invasive approach achieved lower morbidity and mortality rates when compared with surgical management (Molyneux AJ et al 2005).
However, although successful in improving patient care, its durability has been noted to be its Achilles’ heel since the earliest application of this technology. Indeed, after endovascular treatment (EVT) around 20% of patients will experience aneurysm or neck reopening after endovascular embolization, necessitating retreatment (Ferns Sp et al 2009).
Aneurysm recanalization has two primary risks: rebleeding/bleeding and retreatment. In previously ruptured aneurysms, recanalization exposes the patient to an aneurysm rebleed. The overall rate of target aneurysm rebleeding within the first year after coiling in the ISAT trial was 2.7% (26/959), with a mortality rate of 57.7% (15/26). (Molyneux AJ 2005).
The risks associated with retreatment of recanalized aneurysms are considerable. Evidence from a recent meta-analysis indicates a procedural mortality risk for retreatment of a previously coiled ruptured aneurysm of 0.8% for coiling after coiling, 2.2% for flow diverter after coiling, and 5.6% for surgery after coiling, with an overall combined retreatment morbidity/mortality risk of 6–11%. (Muskens IS et al 2019).