DOI QR코드

DOI QR Code

Migrated coil and damaged stent removal during coil embolization, using an additional, retrievable stent: A case report

  • Hee Seung Noh (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Sung Chan Park (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Jong Min Lee (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Soon Chan Kwon (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine)
  • Received : 2022.04.25
  • Accepted : 2022.09.08
  • Published : 2023.06.30

Abstract

One of the common complications that can occur during coil embolization of cerebral aneurysms, is migration of coil lump alone. The removal of these migrated coils has been reported on a few occasions. On the other hand, rare complications would include the migration of the coil with subsequent stent dislocation. Currently, there is no standardized method to correct the complications of stent dislocation, and very few instances of this complication have been reported previously. In this report, we introduce a case of coil migration combined with stent dislocation. This occurred during coil embolization of an unruptured aneurysm of the distal, left internal carotid artery for a 52-year old woman. We retrieved both the damaged stent and migrated coil using another retrievable stent successfully with no more further complications. In the present report, we describe in detail how we corrected the complication successfully stent, and we discuss why this rescue maneuver is reasonable option for the complication mentioned above.

Keywords

References

  1. Abdalkader M, Piotin M, Chen M, Ortega-Gutierrez S, Samaniego E, Weill A, et al. Coil migration during or after endovascular coiling of cerebral aneurysms. J Neurointerv Surg. 2020 May;12(5):505-11.  https://doi.org/10.1136/neurintsurg-2019-015278
  2. Derakhshani S, Rosa S, Chawda S. Detached coil migration that assisted stent migration, during stent assisted coiling of a recurrent aneurysm: a case report. Neuroradiol J. 2011 Oct;24(5):791-5.  https://doi.org/10.1177/197140091102400521
  3. Ding D, Liu KC. Management strategies for intraprocedural coil migration during endovascular treatment of intracranial aneurysms. J Neurointerv Surg. 2014 Jul;6(6):428-31.  https://doi.org/10.1136/neurintsurg-2013-010872
  4. Koseoglu K, Parildar M, Oran I, Memis A. Retrieval of intravascular foreign bodies with goose neck snare. Eur J Radiol. 2004 Mar;49(3):281-5.  https://doi.org/10.1016/S0720-048X(03)00078-0
  5. Kung DK, Abel TJ, Madhavan KH, Dalyai RT, Dlouhy BJ, Liu W, et al. Treatment of endovascular coil and stent migration using the Merci retriever: report of three cases. Case Rep Med. 2012;2012:242101. 
  6. Leslie-Mazwi TM, Heddier M, Nordmeyer H, Stauder M, Velasco A, Mosimann PJ, et al. Stent retriever use for retrieval of displaced microcoils: a consecutive case series. AJNR Am J Neuroradiol. 2013 Oct;34(10):1996-9.  https://doi.org/10.3174/ajnr.A3552
  7. Lessne ML, Shah P, Alexander MJ, Barnhart HX, Powers CJ, Golshani K, et al. Thromboembolic complications after Neuroform stent-assisted treatment of cerebral aneurysms: the Duke Cerebrovascular Center experience in 235 patients with 274 stents. Neurosurgery. 2011 Aug;69(2):369-75  https://doi.org/10.1227/NEU.0b013e31821bc49c
  8. O'Hare AM, Rogopoulos AM, Stracke PC, Chapot RG. Retrieval of displaced coil using a Solitaire® stent. Clin Neuroradiol. 2010 Dec;20(4):251-4.  https://doi.org/10.1007/s00062-010-0020-y
  9. Parthasarathy R, Gupta V, Goel G, Mahajan A. Solitaire sten-tectomy: 'deploy and engage' and 'loop and snare' techniques. J Neurointerv Surg. 2018 May;10(5):e6. 
  10. Simgen A, Kettner M, Webelsiep FJ, Tomori T, Muhl-Benninghaus R, Yilmaz U, et al. Solitaire stentectomy using a stent-retriever technique in a porcine model. Clin Neuroradiol. 2021 Jun;31(2):475-82.  https://doi.org/10.1007/s00062-020-00906-1
  11. Singh DP, Kwon SC, Huang L, Lee WJ. Retrieval of distally migrated coils with detachable intracranial stent during coil embolization of cerebral aneurysm. J Cerebrovasc Endovasc Neurosurg. 2016 Mar;18(1):48-54.  https://doi.org/10.7461/jcen.2016.18.1.48
  12. Vora N, Thomas A, Germanwala A, Jovin T, Horowitz M. Retrieval of a displaced detachable coil and intracranial stent with an L5 Merci Retriever during endovascular embolization of an intracranial aneurysm. J Neuroimaging. 2008 Jan;18(1):81-4. https://doi.org/10.1111/j.1552-6569.2007.00165.x