A Case of a Ruptured Distal ACA Aneurysm treated with Coil Removal and Aneurysmal Clipping for Delayed Coil Migration

Abstract

A 63 year old male with a ruptured distal ACA aneurysm underwent coil embolization. The migration of a small coil into the parent vessel was observed procedurally, that had led to a thrombus formation. We successfully performed aggressive antithrombotic therapy with ozagrel sodium and aspirin as a conservative therapy immediately after the presentation of the thrombus. The five week follow up angiogram revealed a delayed worsening of the coil migration we eventually had to perform surgical intervention to resolve the adverse event. Coil migration is a relatively rare complication. However, it can lead to a critical prognosis if either parent vessel occlusion or distal embolization occurs. We herein report our case and discuss the management strategy including the endovascular and surgical approaches, and also provide a review of the relevant literature.