Introduction: Endovascular treatment of cerebral aneurysms is an appropriate option. In patients with wide neck can be chose embolization with coils with stent assisted or flow diverter. In complex aneurysms, endovascular treatment has incomplete occlusion rates, so alternatives are sought as the Penumbra® coil, which is a thicker coil, therefore it has a potential effect of being more efficient for packaging and more cost effective, because better packaging is achieved with fewer coils and faster.

Clinical case: Presents itself the case of a 48-year-old patient, a time of illness of 8 months, with a decreased visual acuity in the left eye, sporadic headache, oppressive and global type with AVS 4/10. The cerebral angiography evidenced a saccular aneurysm of the ophthalmic segment of the left internal carotid of 15.04x11.53mm, with a 9.78mm wide neck, not broken, Barami type IA. They decide to embolize with 7 Penumbra® coils with previous placement of an LVIS® stent, achieving adequate compaction and total occlusion of the aneurysm as evidenced by immediate postoperative angiography at 6-month control, yielding the patient's clinic without any complications.

Conclusion: Penumbra® coils are an efficient alternative and cost effective of embolization in large aneurysms, and the use of stent is an ideal aid in cases of associated wide neck.