Korean J Cerebrovasc Surg.  2009 Sep;11(3):118-121.

Management of a Complicated Cerebral Aneurysm with Distal Migration of a Detachable Coil: A Case Report

• Park H
• Hong CK
• Suh SH
• Ahn JY
• Joo JY

Abstract

We describe our experience in which the migration of a coil into the parent artery occurred during the coil embolization. A feared complication during coil embolization of cerebral aneurysm is parent artery occlusion by migration of a detachable coil. Obstruction with migration of the coil into the parent artery may be especially hard to solve with an endovascular procedure. The patient had an unruptured internal carotid artery trunk aneurysm where endovascular treatment was performed with detachable coils. One of the packed coils escaped from the sac and migrated into the distal middle cerebral artery (MCA). Cerebral angiography demonstrated non-filling of a number of MCA branches. Repeated attempts at endovascular retrieval of the migrated coil were unsuccessful. Only after an emergent arteriotomy the migrated coil could be successfully removed. Subsequently, endovascular intra-arterial thrombolysis was required to dissolve the thrombus formed postoperatively in the distal MCA. The patient fully recovered with no neurological deficit. In our case a combined surgical and endovascular treatment of coil migration were performed.

Keyword

Coil migrationm; Coil retrieval; Arteriotomy; Thrombolysis; Cerebral aneurysm

MeSH Terms

Aneurysm
Arteries
Carotid Artery, Internal
Cerebral Angiography
Endovascular Procedures
Humans
Intracranial Aneurysm
Middle Cerebral Artery
Parents
Thrombosis
United Nations