Fig. 1.

(A) Brain computed tomography shows subarachnoid hemorrhage with intraventricular hemorrhage (white arrows). (B) Magnetic resonance angiography showed aneurysmal dilatation of the posterior communicating artery (black arrow). (C) Rotational 3-dimensional angiography reveals bilobulated aneurysm of posterior communicating artery (white dotted arrow). (D) After deployment of a 4 mm × 20 mm solitaire FR stent, jailing or coil through techniques using 2 mm-3 mm sized MICRUSPHERE CERECYTE coils were attempted to fill the upper or lower lobes of the aneurysm, but failed. (E) Instead of deploying a coil in each lobe first, a framing coil was placed at the isthmus of the fused portion of the bilobulated aneurysms using a 2 mm × 2.5 cm MICRUSPHERE CERECYTE coil (white arrow). (F and G) A microcatheter was positioned at the lower lobe and upper lobes sequentially and additional coils were inserted (dotted white arrows). (H and I) Subtotal occlusion was achieved with minimal contrast filling of the aneurysm neck.