Extended monitoring of re-coiled cerebral aneurysms after initial postcoiling recanalization: Safety and durability of repeat coil embolization

•Repeat embolization for recurred aneurysm is not favored due to intrinsic technical challenge, and the projected durability of re-coiled aneurysms remains unclear.•Multivariable Cox regression analysis linked re-recanalization to initial saccular neck width and ADPKD.•Stent implantation and successful occlusion at second coiling were protective against further recanalization.•The more recent the second embolization was performed, the lower the risk of further recurrence.•Repeat coil embolization is a safe therapeutic option for recanalized cerebral aneurysms. In the endovascular era, postcoiling recanalization of cerebral aneurysms is occurring with greater frequency. Repeat coiling is usually done to prevent rebleeding, although long-term outcomes of re-embolization have yet to be adequately investigated. The present study was undertaken to assess clinical and radiographic outcomes of re-embolization in recanalized aneurysms, focusing on procedural safety, efficacy, and durability. In this retrospective review, we examined 308 patients with 310 recurrent aneurysms. All lesions were re-coiled, once major recanalization (after initial coil embolization) was established. Medical records and radiologic data amassed during extended follow-up were then subject to review. Cox proportional hazards regression analysis was undertaken to identify risk factors for subsequent recurrence. During a lengthy follow-up (mean, 40.2 ± 33.0 months), major recanalization developed again in 87 aneurysms (28.1%). Multivariable Cox regression analysis linked re-recanalization to initial saccular neck width (p=.003) and autosomal dominant polycystic kidney disease (ADPKD; p