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Fig 1. A 57-year-old woman, 10 months post-subarachnoid hemorrhage and endovascular coiling of a right PcomA aneurysm. A, C, and E, Multiple oblique images taken from a rotational DSA. Although a small neck residual is noted (arrowheads in A and C), there is no evidence of contrast within the actual coil mass (short arrows in A, C, and E). Matching oblique MIP reconstructions of CE-MRA performed 29 days later reveal a much larger aneurysmal recurrence (short arrows in B, D, and F). This larger extent of recurrent aneurysm is difficult to appreciate on the rotational DSA images because it is surrounded by the coil mass, which attenuates the photons passing through it and creates the coil helmet effect. Note that the PcomA artery adjacent to the aneurysm is well demonstrated on both DSA and CE-MRA (long arrows in A–F).
