A Case of Successful Retrieval Using a Stent Retriever for Coil Migration during Parent Artery Occlusion

Abstract

Coil migration during cerebral aneurysm embolization is uncommon but poses significant technical challenges. We report a 58-year-old woman with subarachnoid hemorrhage caused by a small dissecting aneurysm of the distal vertebral artery, located beyond the origin of the posterior inferior cerebellar artery (PICA). Parent artery occlusion was performed. After completion of coil embolization, several finishing coils migrated into the PICA during microcatheter withdrawal. A microcatheter was navigated into the PICA, a stent retriever was deployed, and the migrated coils were captured between the stent retriever and microcatheter and removed en bloc. While a snare catheter is generally the first-line option for distal coil retrieval, a stent retriever can be an effective alternative when a microcatheter can be advanced into small or tortuous vessels.