Fig 1.

Case 1, a 54-year-old man with SAH.

A, Right internal carotid angiogram shows a large aneurysm of middle cerebral artery bifurcation. The inferior division (M2) is incorporated with the neck.

B, The aneurismal configurations are visualized in 3D image.

C, Two microcatheters with different markers are positioned within the aneurysm. The microcatheters have different distal shaping.

D, Two coils (GDC-10; 5 mm × 15 cm) deployed via two microcatheters. Each coil occupies different parts of the aneurysm, and simultaneously they are mixed at the central part. In this case, to make a more complicated mixture of the two coils, the second coil is being advanced before complete deployment of the first coil.

E, After detachment of the first coil, the third coil advanced within the aneurysm. The second coil is not detached until a more stable coil mass is obtained.

F, Angiogram obtained immediately after embolization shows compact occlusion of the aneurismal sac and patent inferior division (M2). There is small neck remnant around the inferior division.