Late Coil Migration after Embolization of Cerebral Aneurysms – Case Series

Abstract

Background Coil migration after cerebral aneurysm embolization is a very rare complication. It can take place early or late in the postoperative period, evolving asymptomatic and causing severe neurological deficits. Ruptured aneurysms of anterior communicant artery were the most frequent reported examples in the literature. Case Report We report three cases of patients with unruptured aneurysms treated with coils and remodeling balloon technique. The first case was that of a left posterior communicating artery aneurysm with coil migration to a distal cortical branch of ipsilateral middle cerebral artery (MCA). The patient had mild paresthesia in the arm for a few days. The second one was a fenestrated basilar artery aneurysm with coil migration to the P2 segment of the left posterior cerebral artery. The patient was fully asymptomatic. The third case was a MCA aneurysm with coil migration to the M3 segment. There were no ischemic complications, and all patients underwent a new endovascular procedure. Conclusions Coil migration is a rare but not always severe complication. Antiplatelet agents are recommended even if the coil migration is asymptomatic.

Coil migration during or after endovascular coiling of cerebral aneurysms

“…Our study showed that delayed migration is more common than previously reported. Only a handful of case reports and one case series of delayed migration have been described in the literature, which also included cases of partial migration 11 16–18…”

Aspirin Preventing Occlusion after Coil Migration into the Distal Anterior Cerebral Artery

“…Coil migration has been reported in 0.3-6% of cases [2]. However, there are only nine case reports on silent coil migration (ranging from three days to six months) [2][3][4]. We present a rare case of immediate silent coil migration into the pericallosal artery, without distal occlusion following successful embolization.…”