A, This 50-year-old woman was admitted with a WFNS grade I SAH with a thick clot localized around the right carotid cistern (axial noncontrast CT scan). B and C, She was found to have a 9-mm elongated right superior hypophyseal aneurysm (B, oblique projection) for which coil embolization was performed with near-complete occlusion (C, oblique projection). D, A follow-up DSA 6 months later showed recurrence of the aneurysm (oblique projection). The recurrence was treated with a Pipeline Embolization Device (PED, Chestnut Medical Technologies, Menlo Park, California). E and F, Oblique projections, early arterial phase (E) and late venous phase (F) after PED deployment, show stasis of contrast within the recurrent portion of the neck.