A Case of Retrieval of a Migrated Coil with a Stent Retriever

Abstract

Objective: Coil migration is a complication related to endovascular coil embolization. In this study, we report a patient in whom an intraoperatively migrated coil was successfully retrieved using a stent retriever.Case Presentation: A 57-year-old male. To treat an unruptured aneurysm of the right internal carotid artery, endovascular coil embolization was performed. During embolization, one end of a framing coil migrated into the parent artery, and it was retrieved using a microsnare. However, this resulted in the extra-aneurysmal deviation of a filling coil. We tried to retrieve it using a microsnare, but the formation of a coil mass made retrieval difficult. Eventually, retrieval with a stent retriever was successful. After operation, mild subarachnoid hemorrhage and slight muscle weakness of the left upper/ lower limbs were observed, but recovery was achieved during the course, and the patient was discharged. Conclusion:To our knowledge, no study has reported retrieval with a stent retriever for the management of coil migration in Japan. However, this method was considered to be effective. We report this patient, and review the literature.

Parent artery stenting as a rescue management for stretched coils during cerebral aneurysms embolization: Report of three cases and review of literature

“…14 Four cases were symptomatic but had no permanent complications. [15][16][17] Interestingly 5 years following CE, one of the patients developed a 30-minutes right heminumbness which was correspondent to a migrated stretched coil that extended down to the descending aorta. 18 Balloon-assisted coil reimplantation technique was utilized in three patients, coil retrieval in 15 patients, coil crushing against the vessel wall in five patients while burring the trailing end of the coil was adopted in six patients (Table 1).…”

“…Observing that the displaced coil proximally shifted hand in hand while retracting the expanded stent, they continued coil retrieval concomitant with partial stent resheathing till the coil is entirely withdrawn. Similarly, Fujii et al 17 reported the use of Trevo XP ProVue in the successful retrieval of a displaced coil mass out of an incidentally discovered cavernous ICA aneurysm into the MCA bifurcation after failed retrieval via the snaring device.…”