{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:29:48Z","timestamp":1769725788982,"version":"3.49.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,8,4]]},"abstract":"\n BACKGROUND<\/jats:title>\n Metal artifacts from clips and coils can interfere with follow-up imaging of treated aneurysms using CT or MRI. The authors report a case in which the gap between the clip and coil mass helped predict aneurysm recurrence and occlusion after clipping and coil embolization.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 50-year-old woman underwent craniotomy and clipping for a left internal carotid artery (ICA)\u2013posterior communicating artery (PCoA) aneurysm at another hospital 22 years earlier. She presented to the authors\u2019 hospital with a headache and was diagnosed with subarachnoid hemorrhage. Cerebral angiography revealed recurrence of the left ICA-PCoA aneurysm, and coil embolization was performed. Because of the metal artifacts from the clip and coils, it was difficult to evaluate aneurysm recurrence using CT angiography and MR angiography. Serial skull radiographs revealed an increasing gap between the clip and coil mass, along with flattening of the coil mass, suggesting recurrence. Follow-up cerebral angiography confirmed the recurrence, and a flow diverter was placed. At 6 months after placement, skull radiographs revealed a reduction in the gap, indicating occlusion. Cerebral angiography confirmed complete aneurysm occlusion.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n In cases with significant metal artifacts from clips and coils, the gap between the clip and coil mass observed on skull radiographs may help predict aneurysm recurrence and occlusion.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25286<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25286","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T06:35:55Z","timestamp":1754289355000},"source":"Crossref","is-referenced-by-count":0,"title":["Gap between the clip and coil mass as a predictor of aneurysm recurrence and occlusion: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Takuya","family":"Osuki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5710-7456","authenticated-orcid":true,"given":"Hiroyuki","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minami","family":"Uezato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Kinosada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0738-760X","authenticated-orcid":true,"given":"Yoshitaka","family":"Kurosaki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"J Cerebrovasc Endovasc Neurosurg","first-page":"1","article-title":"Imaging follow-up strategy after endovascular treatment of Intracranial aneurysms: a literature review and guideline recommendations","volume":"26","author":"Cho","year":"2024","unstructured":"Cho YHChoi JHuh CWImaging follow-up strategy after endovascular treatment of Intracranial aneurysms: a literature review and guideline recommendations. J Cerebrovasc Endovasc Neurosurg. 2024;26(1):1-10."},{"issue":"3","key":"bib2","series-title":"Tomography","first-page":"1608","article-title":"Follow-up assessment of intracranial aneurysms treated with endovascular coiling: comparison of compressed sensing and parallel imaging time-of-flight magnetic resonance angiography","volume":"8","author":"Vornetti","year":"2022","unstructured":"Vornetti GBartiromo FToni FFollow-up assessment of intracranial aneurysms treated with endovascular coiling: comparison of compressed sensing and parallel imaging time-of-flight magnetic resonance angiography. Tomography. 2022;8(3):1608-1617."},{"issue":"6","key":"bib3","series-title":"AJNR. Am J Neuroradiol","first-page":"887","article-title":"Differential subsampling with Cartesian ordering\u2013MRA for classifying residual treated aneurysms","volume":"43","author":"Shahrouki","year":"2022","unstructured":"Shahrouki PGupta RBelani PDifferential subsampling with Cartesian ordering\u2013MRA for classifying residual treated aneurysms. AJNR. Am J Neuroradiol. 2022;43(6):887-892."},{"issue":"7","key":"bib4","series-title":"Neuroradiology","first-page":"649","article-title":"Follow-up CT and CT angiography after intracranial aneurysm clipping and coiling-improved image quality by iterative metal artifact reduction","volume":"59","author":"Bier","year":"2017","unstructured":"Bier GBongers MNHempel JMFollow-up CT and CT angiography after intracranial aneurysm clipping and coiling-improved image quality by iterative metal artifact reduction. Neuroradiology. 2017;59(7):649-654."},{"issue":"3","key":"bib5","series-title":"Neurol Med Chir (Tokyo)","first-page":"193","article-title":"Usefulness of 3 Tesla ultrashort echo time magnetic resonance angiography (UTE-MRA, SILENT-MRA) for the evaluation of the mother vessel after cerebral aneurysm clipping: case series of 19 patients","volume":"61","author":"Katsuki","year":"2021","unstructured":"Katsuki MNarita NIshida NUsefulness of 3 Tesla ultrashort echo time magnetic resonance angiography (UTE-MRA, SILENT-MRA) for the evaluation of the mother vessel after cerebral aneurysm clipping: case series of 19 patients. Neurol Med Chir (Tokyo). 2021;61(3):193-203."},{"issue":"2","key":"bib6","series-title":"AJNR Am J Neuroradiol","first-page":"337","article-title":"Efficacy of skull plain films in follow-up evaluation of cerebral aneurysms treated with detachable coils: quantitative assessment of coil Mass.","volume":"36","author":"Ahn","year":"2015","unstructured":"Ahn SJKim BMJung WSSuh SH.Efficacy of skull plain films in follow-up evaluation of cerebral aneurysms treated with detachable coils: quantitative assessment of coil Mass. AJNR Am J Neuroradiol. 2015;36(2):337-341."},{"issue":"3","key":"bib7","series-title":"Neurol Med Chir (Tokyo)","first-page":"118","article-title":"Usefulness of craniograms in discriminating coiled intracranial aneurysms requiring retreatment","volume":"62","author":"Yasuda","year":"2022","unstructured":"Yasuda RSatow THashimura NNishimura MTakahashi JCKataoka H.Usefulness of craniograms in discriminating coiled intracranial aneurysms requiring retreatment. 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J Cerebrovasc Endovasc Neurosurg. 2021;23(3):221-232."},{"issue":"11","key":"bib11","series-title":"Acta Neurochir","first-page":"1153","article-title":"Aneurysmal remnants after microsurgical slipping: classification and results from a prospective angiographic study (in a consecutive series of 305 operated intracranial aneurysms)","volume":"140","author":"Sindou","year":"1998","unstructured":"Sindou MAcevedo JCTurjman F.Aneurysmal remnants after microsurgical slipping: classification and results from a prospective angiographic study (in a consecutive series of 305 operated intracranial aneurysms). Acta Neurochir. 1998;140(11):1153-1159."},{"key":"bib12","series-title":"Clin Neurol Neurosurg","first-page":"110","article-title":"Therapeutic strategies for residual or recurrent intracranial aneurysms after microsurgical clipping","volume":"173","author":"Kim","year":"2018","unstructured":"Kim JHChung JHuh SKTherapeutic strategies for residual or recurrent intracranial aneurysms after microsurgical clipping. Clin Neurol Neurosurg. 2018;173:110-114."},{"issue":"5","key":"bib13","series-title":"J Neuroendovasc Ther","first-page":"250","article-title":"A case of coil embolization with crossing Y-configuration stenting for a recurrent IC-PC aneurysm after clipping","volume":"16","author":"Sato","year":"2022","unstructured":"Sato SKokubo YKawanami KItagaki HMatsumoto YSonoda Y.A case of coil embolization with crossing Y-configuration stenting for a recurrent IC-PC aneurysm after clipping. J Neuroendovasc Ther. 2022;16(5):250-256."},{"issue":"7","key":"bib14","series-title":"J Neurointerv Surg","first-page":"689","article-title":"Combination release of chemokines from coated coils to target aneurysm healing","volume":"15","author":"Laurent","year":"2023","unstructured":"Laurent DLucke-Wold BDodd WSCombination release of chemokines from coated coils to target aneurysm healing. J Neurointerv Surg. 2023;15(7):689-694."},{"key":"bib15","series-title":"Interv Neuroradiol","article-title":"Efficacy and safety of flow diverters in retreatment of recurrent intracranial aneurysms\u2014a systematic review and meta-analysis","author":"Zarrintan","year":"Published online September 14,","unstructured":"Zarrintan AGhozy SMaroufi SFEfficacy and safety of flow diverters in retreatment of recurrent intracranial aneurysms\u2014a systematic review and meta-analysis. Interv Neuroradiol. 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J Cerebrovasc Endovasc Neurosurg. 2024;26(1):1-10."},{"issue":"3","key":"bib2","series-title":"Tomography","first-page":"1608","article-title":"Follow-up assessment of intracranial aneurysms treated with endovascular coiling: comparison of compressed sensing and parallel imaging time-of-flight magnetic resonance angiography","volume":"8","author":"Vornetti","year":"2022","unstructured":"Vornetti GBartiromo FToni FFollow-up assessment of intracranial aneurysms treated with endovascular coiling: comparison of compressed sensing and parallel imaging time-of-flight magnetic resonance angiography. Tomography. 2022;8(3):1608-1617."},{"issue":"6","key":"bib3","series-title":"AJNR. Am J Neuroradiol","first-page":"887","article-title":"Differential subsampling with Cartesian ordering\u2013MRA for classifying residual treated aneurysms","volume":"43","author":"Shahrouki","year":"2022","unstructured":"Shahrouki PGupta RBelani PDifferential subsampling with Cartesian ordering\u2013MRA for classifying residual treated aneurysms. AJNR. Am J Neuroradiol. 2022;43(6):887-892."},{"issue":"7","key":"bib4","series-title":"Neuroradiology","first-page":"649","article-title":"Follow-up CT and CT angiography after intracranial aneurysm clipping and coiling-improved image quality by iterative metal artifact reduction","volume":"59","author":"Bier","year":"2017","unstructured":"Bier GBongers MNHempel JMFollow-up CT and CT angiography after intracranial aneurysm clipping and coiling-improved image quality by iterative metal artifact reduction. Neuroradiology. 2017;59(7):649-654."},{"issue":"3","key":"bib5","series-title":"Neurol Med Chir (Tokyo)","first-page":"193","article-title":"Usefulness of 3 Tesla ultrashort echo time magnetic resonance angiography (UTE-MRA, SILENT-MRA) for the evaluation of the mother vessel after cerebral aneurysm clipping: case series of 19 patients","volume":"61","author":"Katsuki","year":"2021","unstructured":"Katsuki MNarita NIshida NUsefulness of 3 Tesla ultrashort echo time magnetic resonance angiography (UTE-MRA, SILENT-MRA) for the evaluation of the mother vessel after cerebral aneurysm clipping: case series of 19 patients. Neurol Med Chir (Tokyo). 2021;61(3):193-203."},{"issue":"2","key":"bib6","series-title":"AJNR Am J Neuroradiol","first-page":"337","article-title":"Efficacy of skull plain films in follow-up evaluation of cerebral aneurysms treated with detachable coils: quantitative assessment of coil Mass.","volume":"36","author":"Ahn","year":"2015","unstructured":"Ahn SJKim BMJung WSSuh SH.Efficacy of skull plain films in follow-up evaluation of cerebral aneurysms treated with detachable coils: quantitative assessment of coil Mass. AJNR Am J Neuroradiol. 2015;36(2):337-341."},{"issue":"3","key":"bib7","series-title":"Neurol Med Chir (Tokyo)","first-page":"118","article-title":"Usefulness of craniograms in discriminating coiled intracranial aneurysms requiring retreatment","volume":"62","author":"Yasuda","year":"2022","unstructured":"Yasuda RSatow THashimura NNishimura MTakahashi JCKataoka H.Usefulness of craniograms in discriminating coiled intracranial aneurysms requiring retreatment. Neurol Med Chir (Tokyo). 2022;62(3):118-124."},{"issue":"2","key":"bib8","series-title":"J Cerebrovasc Endovasc Neurosurg","first-page":"108","article-title":"Utility of skull X-rays in identifying recurrence of coiled cerebral aneurysms","volume":"23","author":"Chen","year":"2021","unstructured":"Chen PRLopez-Rivera VConner CRUtility of skull X-rays in identifying recurrence of coiled cerebral aneurysms. J Cerebrovasc Endovasc Neurosurg. 2021;23(2):108-116."},{"issue":"suppl 1","key":"bib9","series-title":"Neurosurgery","first-page":"S13","article-title":"Mechanism of action and biology of flow diverters in the treatment of intracranial aneurysms","volume":"86","author":"Ravindran","year":"2020","unstructured":"Ravindran KCasabella AMCebral JBrinjikji WKallmes DFKadirvel R.Mechanism of action and biology of flow diverters in the treatment of intracranial aneurysms. Neurosurgery. 2020;86(suppl 1):S13-S19."},{"issue":"3","key":"bib10","series-title":"J Cerebrovasc Endovasc Neurosurg","first-page":"221","article-title":"Endovascular treatment of residual or recurrent intracranial aneurysms after surgical clipping","volume":"23","year":"2021","unstructured":"da Silva J\u00faniorNRTrivelatoFPNakiriGS, et al. Endovascular treatment of residual or recurrent intracranial aneurysms after surgical clipping. J Cerebrovasc Endovasc Neurosurg. 2021;23(3):221-232."},{"issue":"11","key":"bib11","series-title":"Acta Neurochir","first-page":"1153","article-title":"Aneurysmal remnants after microsurgical slipping: classification and results from a prospective angiographic study (in a consecutive series of 305 operated intracranial aneurysms)","volume":"140","author":"Sindou","year":"1998","unstructured":"Sindou MAcevedo JCTurjman F.Aneurysmal remnants after microsurgical slipping: classification and results from a prospective angiographic study (in a consecutive series of 305 operated intracranial aneurysms). Acta Neurochir. 1998;140(11):1153-1159."},{"key":"bib12","series-title":"Clin Neurol Neurosurg","first-page":"110","article-title":"Therapeutic strategies for residual or recurrent intracranial aneurysms after microsurgical clipping","volume":"173","author":"Kim","year":"2018","unstructured":"Kim JHChung JHuh SKTherapeutic strategies for residual or recurrent intracranial aneurysms after microsurgical clipping. Clin Neurol Neurosurg. 2018;173:110-114."},{"issue":"5","key":"bib13","series-title":"J Neuroendovasc Ther","first-page":"250","article-title":"A case of coil embolization with crossing Y-configuration stenting for a recurrent IC-PC aneurysm after clipping","volume":"16","author":"Sato","year":"2022","unstructured":"Sato SKokubo YKawanami KItagaki HMatsumoto YSonoda Y.A case of coil embolization with crossing Y-configuration stenting for a recurrent IC-PC aneurysm after clipping. J Neuroendovasc Ther. 2022;16(5):250-256."},{"issue":"7","key":"bib14","series-title":"J Neurointerv Surg","first-page":"689","article-title":"Combination release of chemokines from coated coils to target aneurysm healing","volume":"15","author":"Laurent","year":"2023","unstructured":"Laurent DLucke-Wold BDodd WSCombination release of chemokines from coated coils to target aneurysm healing. J Neurointerv Surg. 2023;15(7):689-694."},{"key":"bib15","series-title":"Interv Neuroradiol","article-title":"Efficacy and safety of flow diverters in retreatment of recurrent intracranial aneurysms\u2014a systematic review and meta-analysis","author":"Zarrintan","year":"Published online September 14,","unstructured":"Zarrintan AGhozy SMaroufi SFEfficacy and safety of flow diverters in retreatment of recurrent intracranial aneurysms\u2014a systematic review and meta-analysis. Interv Neuroradiol. 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