{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:59:40Z","timestamp":1785452380311,"version":"3.56.0"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Duplicated middle cerebral artery (DMCA) aneurysms are rare, and their management can be challenging owing to their unique anatomical configuration and altered hemodynamics. We herein present a case of a large DMCA aneurysm that recurred 3 years after initial coil embolization. The patient underwent surgical clipping but experienced postoperative hemorrhage, which required the placement of a flow diverter as salvage treatment. This case highlights the potential for DMCA aneurysm recurrence and the importance of considering multiple treatment modalities.<\/jats:p>","DOI":"10.1055\/s-0046-1817808","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T23:58:39Z","timestamp":1774396719000},"page":"623-628","source":"Crossref","is-referenced-by-count":0,"title":["Recurrent Duplicated Middle Cerebral Artery Aneurysm Treated with Flow Diverter After Coil Embolization and Surgical Clipping, A Case Report and Literature Review"],"prefix":"10.1055","volume":"21","author":[{"given":"Natsuki","family":"Shozuhara","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yushiro","family":"Take","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1838-3797","authenticated-orcid":false,"given":"Hiroki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaima","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Mochizuki","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Tanikawa","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akina","family":"Iwasaki","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukie","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8852-0208","authenticated-orcid":false,"given":"Takuma","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oudrhiri Mohammed","family":"Yassaad","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Department of Endovascular Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Iihoshi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Kohyama","sequence":"additional","affiliation":[{"name":"Department of Endovascular Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Kurita","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"issue":"01","key":"ref1","first-page":"45","article-title":"Middle cerebral artery variations: duplicated and accessory arteries","volume":"19","author":"M Komiyama","year":"1998","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"564797","DOI":"10.3389\/fneur.2020.564797","article-title":"The clinical characteristics and treatment considerations for intracranial aneurysms associated with middle cerebral artery anomalies: a systematic review","volume":"11","author":"K Hou","year":"2020","journal-title":"Front Neurol"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"105773","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.105773","article-title":"Duplicated middle cerebral artery aneurysms treated by coil embolization; a report of two cases and literature review","volume":"30","author":"K Fujimoto","year":"2021","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.surneu.2005.05.032","article-title":"Treatment of unruptured duplicated middle cerebral artery aneurysm: case report","volume":"65","author":"Y Kai","year":"2006","journal-title":"Surg Neurol"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1007\/s003300050960","article-title":"Middle cerebral artery variations detected by magnetic resonance angiography","volume":"10","author":"A Uchino","year":"2000","journal-title":"Eur Radiol"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"213","DOI":"10.2176\/nmc.50.213","article-title":"Coil embolization of a ruptured aneurysm arising from a middle cerebral artery fenestration\u2013case report","volume":"50","author":"S Yamaguchi","year":"2010","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"09","key":"ref7","doi-asserted-by":"crossref","first-page":"653","DOI":"10.2176\/nmc.51.653","article-title":"\u201cKissing\u201d aneurysms of the internal carotid artery treated by coil embolization","volume":"51","author":"C Takahashi","year":"2011","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"27","DOI":"10.4236\/ojmn.2015.51005","article-title":"Unruptured aneurysm at the origin of the duplicated middle cerebral artery treated by coil embolization: a case report","volume":"5","author":"S KT Toyota","year":"2015","journal-title":"Open J Mod Neurosurg"},{"issue":"05","key":"ref9","first-page":"391","article-title":"[A ruptured aneurysm at the origin of a duplicated middle cerebral artery, treated by coil embolization: a case report]","volume":"45","author":"K Hayashi","year":"2017","journal-title":"No Shinkei Geka"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.wneu.2018.09.154","article-title":"Ruptured duplicated middle cerebral artery aneurysm successfully treated by coil embolization with balloon remodeling","volume":"120","author":"C OA Tsang","year":"2018","journal-title":"World Neurosurg"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"194","DOI":"10.25259\/SNI_219_2024","article-title":"Endovascular treatment of unruptured aneurysm arising from duplicate origin of the middle cerebral artery - a case report and literature review","volume":"15","author":"N Tanoue","year":"2024","journal-title":"Surg Neurol Int"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1148\/radiol.13120099","article-title":"Pipeline for uncoilable or failed aneurysms: results from a multicenter clinical trial","volume":"267","author":"T Becske","year":"2013","journal-title":"Radiology"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1136\/neurintsurg-2019-015091","article-title":"Prospective study on embolization of intracranial aneurysms with the pipeline device: the PREMIER study 1 year results","volume":"12","author":"R A Hanel","year":"2020","journal-title":"J Neurointerv Surg"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.3171\/2016.4.JNS16147","article-title":"Patency of anterior circulation branch vessels after Pipeline embolization: longer-term results from 82 aneurysm cases","volume":"126","author":"L Rangel-Castilla","year":"2017","journal-title":"J Neurosurg"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1115\/1.2796081","article-title":"Modeling of flow in a straight stented and nonstented side wall aneurysm model","volume":"119","author":"M Aenis","year":"1997","journal-title":"J Biomech Eng"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1093\/jnen\/nlx075","article-title":"Comparative ultrastructural and stereological analyses of unruptured and ruptured saccular intracranial aneurysms","volume":"76","author":"E Korkmaz","year":"2017","journal-title":"J Neuropathol Exp Neurol"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"407","DOI":"10.3171\/jns.2003.98.2.0407","article-title":"Continued growth of and increased symptoms from a thrombosed giant aneurysm of the vertebral artery after complete endovascular occlusion and trapping: the role of vasa vasorum. Case report","volume":"98","author":"K Iihara","year":"2003","journal-title":"J Neurosurg"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"20","DOI":"10.3174\/ajnr.A2370","article-title":"Intra-aneurysmal thrombosis as a possible cause of delayed aneurysm rupture after flow-diversion treatment","volume":"32","author":"Z Kulcs\u00e1r","year":"2011","journal-title":"AJNR Am J Neuroradiol"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0046-1817808.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:39:52Z","timestamp":1785451192000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0046-1817808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,24]]},"references-count":18,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,7,30]]},"published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0046-1817808","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"value":"1793-5482","type":"print"},{"value":"2248-9614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,24]]}}}