Retrieval of a dislocated coil and stent-assisted coiling by Solitaire (R) stent during endovascutar treatment of an intracraniat aneurysm

Abstract

Coil embolization is an effective and safe procedure for the treatment of intracranial aneurysms. It is known to produce good clinical outcomes and provide sufficient protec- tion against recurrent bleeding [1-4]. In a systematic review, Brilstra et al. retrieved 19 (1.4%) re-bleeding episodes, 36 (2.6%) aneurysmal ruptures, 124 (9%) ischemic and 55 (4%) permanent complications in 1383 patients with ruptured and unruptured aneurysms treated with coil embolization. Complications occurring during coil embolization include rupture of aneurysm, arterial dissection, bleeding and microembolic complications. Coil dislocation is another rare complication of coil embolization which occurs in 2-6% of the procedures [3,5-7]. Thromboembolic complications during endovascular treatment could be caused by coil dislocation or thrombus formation in parent vessel because of vasospasm [2]. Dislocation can be fixed by retrieval of the coil from the aneurysm or placement of the coil back in the aneurysm [3,8]. Retrieval of a dislocated coil can be achieved by snares and stent retrievers. We present herein a case where Solitaire® stent (Ev3, Irvine, CA, USA) was used for retrieval of a dislocated coil, which protruded into the proximal part of the internal carotid artery (ICA) during endovascular treatment and secondly for total aneurysm treatment by stent-assisted coiling technique in the same patient.