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Coil migration through two flow-diverting stents

Date

2024-01-18

Authors

Rogers, Patrick Scott
Volders, David
Pickett, Gwynedd
Vandorpe, Robert

Journal Title

Journal ISSN

Volume Title

Publisher

BMJ

Abstract

We report a case of a patient who initially presented with a subarachnoid haemorrhage secondary to a ruptured supraclinoid internal carotid artery (ICA) blister aneurysm. The patient was treated successfully with a flow diverter stent (FD) and coiling; however, a large aneurysm recurrence via a feeding posterior communicating artery (PCOM) was noted on the 1-year follow-up angiogram. During the retreatment, a second FD in the ICA resulted in insufficient aneurysm stasis. Therefore, the decision was made to coil sacrifice the PCOM via posterior circulation access. During the first coil deployment, the distal coil end migrated through the mesh of two overlapping FD into the middle cerebral artery. This complication was a previously unrecognised possibility given the composition of the FD. This case report aims to discuss this process as a potential complication during neurointerventional procedures using these devices.

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Citation

Rogers PS, Volders D, Pickett G, Vandorpe R. Coil migration through two flow-diverting stents. BMJ Case Rep. 2024 Jan 18;17(1):e256863. doi: 10.1136/bcr-2023-256863. PMID: 38238159; PMCID: PMC10806980.