Neuroform stent migration during retrieval of a displaced Penumbra coil in endovascular treatment of carotid-posterior communicating artery aneurysm: Case report

Abstract

Objective: Coil or stent migration during endovascular coiling procedures for intracranial aneurysm can result in devastating thromboembolic complications. We present a case with migration of coils and movement of a Neuroform stent during coil embolization of a left carotid-posterior communicating artery aneurysm. The complication was effectively managed with the use of a gooseneck snare.
Case presentation: A 79-year-old right-handed man with left unruptured carotid-posterior communicating artery aneurysm was treated with stent-assisted coil embolization. During the procedure, a coil got entangled with the stent that had already been placed in the left carotid artery. Retraction of the coil made the coil-stent complex slip to the proximal side of the aneurysm within the left carotid artery. The coil-stent complex was successfully retrieved with a gooseneck snare.
Conclusion: The frequency of stent movement is not particularly high, but the risk must be recognized. Retrieval or repositioning of these migrated foreign bodies should be performed carefully to prevent secondary complication.