Stebner, AlexanderCimflova, PetraBosshart, Salome L.Schüngel, Marie SophieFujiwara, SatoruMilot, GenevieveVolders, DavidUchida, KazutakaHawkes, ChristineMoreu, ManuelFragata, IsabelPaul, AlexandraPensato, UmbertoUlfert, ChristianFrei, DonaldBhogal, PervinderSchaafsma, JoannaNardai, SandorZaidi, SyedAlmekhlafi, MohammedNimjee, ShahidMosimann, PascalKennedy, JamesRempel, JeremyInoa, ViolizaYoshimura, ShinichiRibo, MarcLopes, DemetriusWong, JohnOspel, Johanna2026-01-142026-01-142025-091591-0199PURE: 147418795PURE UUID: ebcc42aa-93c2-4430-9d6e-e5438d63a910Scopus: 105023396540PubMed: 40990642http://hdl.handle.net/10362/199007Publisher Copyright: © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).Background: Intracranial aneurysms are increasingly detected incidentally due to broader use of neuroimaging. Intrasaccular devices are frequently used to prevent rupture, yet standardized follow-up and retreatment strategies remain undefined. We performed a scoping literature review and DELPHI consensus to gauge current practice patterns and expert opinions on managing intracranial aneurysms that were previously treated with intrasaccular devices. Methods: A DELPHI consensus was conducted during an invite-only meeting of international neurointerventional experts. The process was informed by a scoping literature review and included three iterative rounds of structured questionnaires to establish consensus on follow-up imaging timing, modality, and retreatment decision-making. Results: Twenty-four experts participated. The literature review identified 16 key studies, which were presented to the panel. For completely occluded aneurysms, MRA at 6 months was preferred by 58% of participants, with annual imaging favored thereafter. For incompletely occluded aneurysms, 6-month DSA followed by annual imaging was recommended. No consensus was reached on the imaging modality for annual follow-up. Retreatment decisions were primarily driven by aneurysm growth (>2 mm). Endovascular retreatment was preferred over open surgery, with risks such as ischemia and rupture identified as key concerns. Conclusion: This DELPHI consensus highlights current practice trends and open questions in the follow-up and retreatment of aneurysms treated with intrasaccular devices.1438686engAneurysmcoilingendovascularintrasaccularwoven endobridgeRadiology Nuclear Medicine and imagingClinical NeurologyCardiology and Cardiovascular Medicinejournal article10.1177/15910199251380361https://www.scopus.com/pages/publications/105023396540