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This article explores the usage of CTA and DSA in nearly 5000 patients with ruptured aneurysms. During a 5-year period, use of CTA more than doubled to 44% of all patients while the use of DSA remained stable (94–96%). The same trend was observed for patients undergoing coiling or clipping and following treatment the use of imaging increased from 41% to 48%, especially in clipped patients. The use of DSA as a second test is potentially redundant.