Symptomatic delayed coil migration after balloon assisted embolization: An underreported adverse event?

Fonseca, Lino; Najarro-Quispe, Rafael; Rodríguez-Hernández, Ana; Torné, Ramón; Gándara-Sabatini, Dario; Arikán, Fuat; Baños-Carrasco, Pilar

doi:10.1016/j.neucir.2018.02.005

Cited by 4 publications

(2 citation statements)

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“…Detachable balloons, coiling, stent placement and their combinations are all possible techniques for achieving better results. 3,7,8 In traumatic iatrogenic pseudoaneurysms combination of Onyx and balloon assisted coiling has proven to be successful. 1 Jafari et al have confirmed in the case of a pseudoaneurysm in a child that stent placement alongside coiling could be a useful method of choice.…”

Section: Discussionmentioning

confidence: 99%

“…If proper packing of the coil loops is not achieved, soft or ultra-soft coils, used in the final packing of the lumen, may displace even months after the procedure. 8 Both low-density packing and overpacking, as well as coil size and the shape of the aneurysm, might generate instability in the coil mass. Choosing the flow modulation device p64 gives us the benefit of constructing the lumen of the parent vessel by providing faster endothelialization within six months, as opposed to the conventional braided stents that endothelialize for one year or more.…”

Section: Discussionmentioning

confidence: 99%

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Delayed intranasal coil extrusion after internal carotid artery pseudoaneurysm embolization

et al. 2018

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Internal carotid artery (ICA) injury is a rare but potentially life-threatening complication of skull base and neck surgery. Although usually manifested by massive intraoperative haemorrhage, impairment of the ICA might go unnoticed and result in formation of a pseudoaneurysm, causing delayed bleeding. Often additional complications are observed such as thrombosis, spasm, embolism or carotico-cavernous fistula formation. The risk of carotid artery injury in aggressive endonasal skull base surgical interventions ranges from 1% to 9%. Digital subtracted angiography remains the gold standard for evaluation of patients with iatrogenic carotid artery injury as it allows for endovascular treatment at the time of the procedure. Endovascular embolization is currently the preferred method for treating ICA pseudoaneurysms and a successful alternative to the surgical approach. Even though endovascular approaches are considered the safer option, delayed complications have been registered, such as endovascular coil extrusion and migration, which increases the risk of further episodes of bleeding. We present our experience with late coil extrusion in a patient who was previously treated with flow diverter stent and coiling for iatrogenic ICA pseudoaneurysm.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%