Fig 1. A, Left internal carotid artery (ICA) angiogram showing a left middle cerebral artery (MCA) bifurcation aneurysm and an additional distal MCA aneurysm.

B and C, Left ICA angiogram after complete embolization of both MCA aneurysms.

D, Left ICA angiogram 4 days after coil embolization demonstrating severe vasospasms at the distal ICA and proximal MCA.

E, After successful balloon dilation of the ICA and proximal MCA by using a 3-mm balloon occlusion system.

F and G, Six-month follow-up showing partial recanalization of both aneurysms as a result of coil compaction (arrowhead at distal MCA aneurysm).

H and I, Left ICA angiogram after retreatment showing complete occlusion of both MCA aneurysms (arrowhead at distal MCA aneurysm).