**8. Conclusions**

The role of craniotomy in treating recurrent cerebral aneurysms after initial coil embolization has been discussed in detail. The optimal treatment strategy for this lesion should be decided based on the location of the aneurysm, the mechanism of recurrence, the presence or absence of systemic complications, and the performance status of the individual patient. In the case of recurrence by aneurysmal regrowth mechanisms, the choice of direct surgery leads to a low recurrence rate. In direct surgery, clipping without coil mass extraction is safer. The tandem clipping method is a beneficial technique that can achieve complete occlusion of these aneurysms.
