Laparoscopic endoscopic combined surgery for removal of migrated coil after embolization of ruptured splenic artery aneurysm

Abstract

Splenic artery aneurysm is the most common visceral arterial aneurysm. Rupture of aneurysm is a rare event but associated with a high mortality. Endovascular coil embolization of bleeding splenic artery aneurysm has emerged as a promising minimal invasive treatment and considered safer than open surgery in selected patients. Nevertheless, several complications related to coils have been reported, the rarest being coil migration and erosion. We report a case of splenic artery coil migration into the stomach and its successful removal by laparoscopic endoscopy combined surgery.

Multiple Splenic Artery Aneurysms: A Case Report and Review of the Literature

“…However, the application of this technique is limited by intrasplenic MSAAs, infected (mycotic) SAA, tortuous arteries, decreased artery dimensions, and the location of the lesion.In addition, giant aneurysm was not suitable for endovascular treatment, as the aneurysm may involve the intestine, pancreas, and other neighboring organs. Owing to the increasing frequency of endovascular treatment, its main complications, such as coil and stent migration, splenic and intestinal infarction, hemorrhage and aneurysm rupture, fever, and splenic abscess and recanalization, have begun to attract the attention of clinicians (35)(36)(37)(38).…”

A Rare Case of Coil Migration into the Duodenum after Embolization of a Right Colic Artery Pseudoaneurysm

“…Finally, a total of 17 cases, including our case, were reviewed. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Most patients had various underlying illnesses, including chronic pancreatitis or cholecystitis. The common sites of pseudoaneurysms were hepatic, splenic, and gastroduodenal arteries.…”

Endovascular coil erosion into the duodenum following gastroduodenal artery angioembolization

“…In previously reported cases, symptomatic patients with coil migration underwent or were planned to undergo removal of the coil. 1,3,4 A laparotomy and duodenotomy to remove the coil has been previously reported; 5 however, given our patient was asymptomatic and in the context of significant comorbidities, the risks of major surgery were thought to outweigh the benefit of coil extraction in the elective setting. It is worth noting that spontaneous passage of a migrated coil has been previously reported without significant sequelae and therefore this approach would seem reasonable.…”

“…Coil migration following angioembolization of visceral artery pseudoaneurysms is a rare complication of which cases have previously been documented in the literature, most commonly in the setting of renal and splenic artery pseudoaneurysms . Erosion of an endovascular coil into the stomach has previously been reported to cause abdominal pain, weight loss, dyspepsia and severe anaemia requiring blood transfusion . This article reports a case of asymptomatic coil migration into the duodenal lumen following GDA pseudoaneurysm angioembolization identified incidentally at endoscopy and is the first reported case of vascular coil erosion through the duodenum in the literature.…”

“…1,2 Erosion of an endovascular coil into the stomach has previously been reported to cause abdominal pain, weight loss, dyspepsia and severe anaemia requiring blood transfusion. 3,4 This article reports a case of asymptomatic coil migration into the duodenal lumen following GDA pseudoaneurysm angioembolization identified incidentally at endoscopy and is the first reported case of vascular coil erosion through the duodenum in the literature. In previously reported cases, symptomatic patients with coil migration underwent or were planned to undergo removal of the coil.…”