Wrapping and coating of cerebral aneurysms: history, evolution and surgical management after a re-bleed

Wrapping or coating of ruptured cerebral aneurysms was an acceptable method of surgical treatment until the 1980s. Occasionally, patients still present with a re-bleed. Management of these patients can be challenging. The author describes his experience of surgically treating ruptured aneurysms that have been previously wrapped. Technical issues in the surgical treatment are discussed with three illustrative cases of aneurysms at different locations encountered from 1999 to 2003. Despite operative difficulties satisfactory surgical results can be accomplished in the majority of these cases.