Comaneci-assisted coiling of a right posterior communicating artery aneurysm: an unusual case of coil retention

Abstract

Although endovascular embolization has become the main treatment option for intracranial aneurysms,1 2 wide-necked intracranial aneurysms remain difficult to coil.3 Both stent- and balloon-assisted coiling are used for wide-necked aneurysms because they provide a scaffold that protects the parent vessel during coiling.4 5 However, stent-assisted coiling requires dual antiplatelet therapy, which increases the risk of bleeding, whereas balloon-assisted coiling temporarily obstructs blood flow.4 6 7 The Comaneci device (Rapid Medical, Yokneam, Israel) has recently received US Food and Drug Administration approval as a ‘temporary coil embolization assist device’.5 It temporarily covers the aneurysm neck and allows safe coiling, avoiding the disadvantages mentioned above.6–8 A potential complication of Comaneci-assisted coiling is coil retention when it adheres to the device on recapture; this complication should be promptly recognized and managed.5 9 10 In this video, we present an unusual case of coil retention with the Comaneci device (Video 1).Video 1

A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms

“…The temporary neck bridging devices, mainly including the Comaneci device (Rapid Medical, Yokneam, Israel), and the Cascade device (Perflow Medical, St. Netanya, Israel), have attracted a lot of attention in the past decade ( Gupta et al, 2016 ; Sirakov A. et al, 2020 ; Sirakov S. et al, 2020 ; Sioutas et al, 2023 ). , Unlike intrasaccular flow disruption devices, Comaneci and Cascade are metal stents that can be temporarily used for the embolization of IAs, similar in principle to balloon-assisted embolization of IAs ( Sirakov et al, 2022 ).…”