An unruptured basilar artery aneurysm was found due to a history of headaches in a 52-year-old male. The aneurysm was treated with simple coiling. Control angiography indicated near complete occlusion of the aneurysm, and the patient was free from any neurological deficit. Ten years later, the patient suddenly presented with subarachnoid hemorrhage (SAH) (WFNS grade 5) and the digital subtraction angiography (DSA) confirmed recurrence of the aneurysm. After excluding the need to place an external ventricular drainage (EVD), the ruptured aneurysm was then treated by SAC with an Enterprise sized 4.5 mm × 22 mm 3 days after the ictus of SAH. This patient experienced right hemiparesis post procedure, possibly due to cerebral vasospasm, robust packing of coils, and the perforators covered by the stent. Then, we put the patient on rehabilitation and the patient recovered well (mRS = 1). Follow-up DSA 9 months later manifested with persist filling of contrast in the inferior portion of the aneurysm. The patient came to our center seeking for a third treatment. CTA on admission indicated that the aneurysm was fusiform in morphology, possibly a dissecting aneurysm. Based on perceived high risk of rebleeding (according to the irregular shape and history of rupture) and recurrent nature of this aneurysm, we decided on consensus in the interdisciplinary discussion to treat this aneurysm with a single PED and adjunctive coiling. The patient was premedicated with a daily dose of 100 mg aspirin and 75 mg clopidogrel for 5 days. Thromboelastogram (TEG) suggested adequate response to the clopidogrel (inhibition rate 32.8%), so the procedure was performed under general anesthesia with systemic heparinization. Right femoral artery was canalized with an 8F arterial sheath, and a tri-axial system was then constructed with a 8F guiding catheter (Codman, Raynham, Massachusetts, USA), 6 F Navien (ev3/Covidien, Mansfield, Massachusetts, USA), and a Marksman microcatheter (EV3, Irvine, CA, USA). The Marksman was positioned beyond the P2 segment of the left posterior cerebral artery through the Navien. In our center, we used to open the PED distal to the landing zone, like in the PCA or in the distal part of basilar artery, then we would retract the half-opened PED to the target place. However, for this aneurysm with a stent in parent artery, we deployed a 4 × 16-mm sized PED in situ and made sure that the distal end of PED was proximal to the strut of the Enterprise stent so that the PED would not be stuck at the struts of Enterprise. And the proximal end of PED should be distal to the proximal end of the previous stent. As a result, the whole length of PED was within the Enterprise and worked as an inner layer while the Enterprise acted as a scaffold. This complex resembled the double-layer flow diverter FRED. Due to that this aneurysm once ruptured, we further coiled the aneurysm through a pre-jailed Echelon-10 (ev3 Endovascular, Plymouth, MN, USA) microcatheter. Ten coils were used to occlude the aneurysm (for framing, Axium 3D detachable coils 4 mm × 12 cm (ev3, Covidien, Irvine, California, USA); For subsequent filling and finishing, Axium 3D detachable coils 2 mm × 6 cm, 3 mm × 8 cm, 3 mm × 6 cm, 3 mm × 8 cm, and 2 mm × 4 cm; Axium Helical detachable coils 2 mm × 8 cm, and 2 mm × 8 cm (ev3, Covidien, Irvine, California, USA); and MicroPlex 10 HyperSoft helical coils 4 mm × 10 cm and 2 mm × 6 cm (MicroVention, Tustin, California, USA)). After the procedure, the patient recovered from general anesthesia smoothly without any neurological deficit. The patient was treated with dual antiplatelet therapy which consisted of aspirin (100 mg) and clopidogrel (75 mg). Clopidogrel was discontinued at latest follow-up (6 month), and the aspirin (100 mg) was continued for life. DSA follow-up on 6 months showed complete obliteration of the aneurysm, and the patient was symptom free (mRS 0).