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KMID : 1005420090110030118
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Journal of Cerebrovascular and Endovascular Neurosurgery
2009 Volume.11 No. 3 p.118 ~ p.121
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Management of a Complicated Cerebral Aneurysm with Distal Migration of a Detachable Coil : A Case Report
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Park Hun-Ho
Hong Chang-Ki
Suh Sang-Hyun
Ahn Jung-Yong
Joo Jin-Yang
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Abstract
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We describe our experience in which the migration of a coil into the parent artery occurred during the coil embolization. A feared complication during coil embolization of cerebral aneurysm is parent artery occlusion by migration of a detachable coil. Obstruction with migration of the coil into the parent artery may be especially hard to solve with an endovascular procedure. The patient had an unruptured internal carotid artery trunk aneurysm where endovascular treatment was performed with detachable coils. One of the packed coils escaped from the sac and migrated into the distal middle cerebral artery (MCA). Cerebral angiography demonstrated non-filling of a number of MCA branches. Repeated attempts at endovascular retrieval of the migrated coil were unsuccessful. Only after an emergent arteriotomy the migrated coil could be successfully removed. Subsequently, endovascular intra-arterial thrombolysis was required to dissolve the thrombus formed postoperatively in the distal MCA. The patient fully recovered with no neurological deficit. In our case a combined surgical and endovascular treatment of coil migration were performed.
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KEYWORD
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Coil migrationm, Coil retrieval, Arteriotomy, Thrombolysis, Cerebral aneurysm
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