See companion post-clip rerupture case here, which was dedicated to the CARAT study investigators. This one is too. The point of CARAT is that partially treated aneurysms, whether clipped or coiled, do re-rupture. Clipped aneurysms re-rupture less often simply because residual and recurrence is much more frequently seen with coils. Nothing magical about clipping — a clipped residual is a residual and in our opinion all ruptured aneurysms should be treated to 100% completion, except in very special circumstances. A related and huge problem is loss to follow up. Patients assume that their aneurysms are cured and after a few follow up studies for whatever reason do not get follow up and these are the ones we tend to see return with re-rupture. Here is a case, treated 10 years previously in setting of SAH, and lost to follow-up. Grade 2, fortunately
Excellent recovery. Except patient now needs shunt
Conclusion: As above. Patients lost to follow up are at risk of re-rupture. In our institution partially treated ruptured aneurysms are treated to completion.