Endovascular coil embolization through a previously implanted Contour intrasaccular device for recurrent posterior communicating artery aneurysm

Intrasaccular flow diverters such as the Contour Neurovascular System represent a significant advancement in the endovascular management of intracranial aneurysms, particularly those with complex bifurcation morphology. However, complications such as incomplete occlusion or recurrence post-implantation remain prevalent challenges in clinical practice. Depending on the specific failure mode and anatomy, various bailout strategies may involve parent vessel reconstruction with flow diverters or surgical clipping.1–4 This technical video (video 1) shows a novel bailout strategy that integrates adjunctive coil embolization through a pre-existing Contour device to address aneurysm recurrence. Key procedural elements are demonstrated, including microcatheter navigation into the residual aneurysm sac adjacent to the Contour, precise coil deployment into the interstice between the device and the aneurysm wall, and achieving complete angiographic occlusion while preventing any displacement or compromise of functionality of the existing intrasaccular device. This technique exemplifies a viable endovascular rescue approach for selected instances of aneurysm recurrence following Contour treatment, enhancing the therapeutic armamentarium available to clinicians. Video 1 Endovascular coil embolization through a previously implanted Contour intrasaccular device for recurrent posterior communicating artery aneurysm.