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      Endovascular retrieval of a dislocated coil in the peroneal artery with a stent retriever

      case-report

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          Abstract

          We present a patient who underwent successful removal of a fully detached platinum coil from the peroneal artery using a Solitaire ™ stent retriever (Covidien, Irvine, CA) that is usually used in endovascular stroke treatment.

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          Management strategies for intraprocedural coil migration during endovascular treatment of intracranial aneurysms.

          Dale Ding, Kenneth Liu (2014)
          Migration of a coil during endovascular treatment of intracranial aneurysm occurs in 2-6% of cases. The consequences of coil migration vary significantly from minor flow alterations of the parent artery which are asymptomatic to thromboembolic occlusion of major intracranial vessels resulting in large territory infarcts. We performed a comprehensive literature review and identified 37 reported cases of migrated coil retrieval consisting of 10 case reports and six case series. Most of the aneurysms presented with rupture (65%) and were located in the anterior circulation (70%). The endovascular treatment approaches were coil embolization alone (57%), stent-assisted coiling (26%) and balloon remodeling (17%). Endovascular retrieval was performed with microwires, the Alligator Retrieval device, Merci devices, snares and stentrievers. There was a single report of microsurgical extraction following failed endovascular removal and three cases of coil fracture in which the coil fragments were secured to the vessel walls with stents.
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            Intraprocedural retrieval of migrated coils during endovascular aneurysm treatment with the Trevo Stentriever device.

            Kenneth Liu, Dale Ding, Robert Starke … (2014)
            Coil migration during endovascular treatment of intracranial aneurysms occurs in 2-6% of cases. As endovascular coiling of aneurysms has become increasingly popular and as endovascular technology continues to rapidly evolve, the prevalence of intraprocedural coil migration will invariably rise. Since coil masses are highly thrombogenic, migration out of the aneurysm sac into the parent artery may result in large territory infarcts which subsequently manifest as significant neurological morbidity. Therefore safe and timely retrieval of migrated coils is essential to avoiding poor angiographic and clinical outcomes. A 66-year-old woman with an unruptured 5 × 3mm, wide-necked posterior communicating artery aneurysm was referred for endovascular treatment. During coiling with the dual catheter technique, both initially deployed coils dislodged from the aneurysm sac and migrated distally into the middle cerebral artery. After failed retrieval with an Alligator device (Chestnut Medical Technologies, Menlo Park, CA, USA), we used two Trevo devices (Concentric Medical, Mountain View, CA, USA) in succession to successfully retrieve the migrated coils. The aneurysm was then occluded with stent-assisted coil embolization. There were no post-procedural angiographic or clinical complications. The patient was subsequently discharged home without neurological deficit. This case illustrates the first use of the Trevo device for retrieval of migrated coils during endovascular treatment of an intracranial aneurysm to our knowledge. Due to the lack of guidelines defining the standard management of intraprocedural coil migration, current strategies are based on retrospective review of published reports and expert opinion. We present a unique and effective method for endovascular retrieval of displaced coils using a Trevo Stentriever device.
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              Retrieval of migrated coils with stent retrievers: an animal study.

              O Nikoubashman, R. Pjontek, M.-A. Brockmann … (2015)
              Coil migration is a potentially serious complication of endovascular aneurysm treatment. The aim of the study was to systematically investigate the effectiveness of coil retrieval with a stent retriever in an animal model.
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                Author and article information

                Contributors
                Omid Nikoubashman
                Rico Badenschier
                Marguerite Müller
                Carolin Brockmann
                Gerrit Schubert
                Marc-Alexander Brockmann
                Georg Mühlenbruch
                Hans Rainer Clusmann
                Martin Wiesmann
                Journal
                Journal ID (nlm-ta): BJR Case Rep
                Journal ID (iso-abbrev): British Institute of Radiology
                Journal ID (publisher-id): bjrcr
                Title: BJR | case reports
                Publisher: The British Institute of Radiology
                ISSN (Electronic): 2055-7159
                Publication date Collection: 2016
                Publication date (Electronic): 19 January 2016
                Volume: 2
                Issue: 1
                Electronic Location Identifier: 20150278
                Affiliations
                [1] 1 Department of Neuroradiology , University Hospital Aachen, Aachen, Germany
                [2] 2 Institute of Neuroscience and Medicine 4 , Forschungszentrum Jülich GmbH, Jülich, Germany
                [3] 3 Department of Radiology , Helios Klinikum Schwerin, Schwerin, Germany
                [4] 4 Department of Neurosurgery , University Hospital Aachen, Aachen, Germany
                [5] 5 Department of Radiology , Medizinisches Zentrum StädteRegion Aachen GmbH, Würselen, Germany
                Author notes
                Address correspondence to: Dr Omid Nikoubashman E-mail: onikoubashman@ 123456ukaachen.de
                Article
                Publisher-manuscript ID: bjrcr.20150278
                DOI: 10.1259/bjrcr.20150278
                PMC ID: 6195927
                SO-VID: 9e12bba3-0197-498c-bf59-041a89e01e32
                Copyright © © 2016 The Authors. Published by the British Institute of Radiology
                License:

                This is an open access article under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 10 July 2015
                Date revision received : 07 October 2015
                Date revision received : 22 September 2015
                Date accepted : 18 October 2015
                Categories
                Subject: Case Report
                Compound subject: bjrcr, BJR|case reports
                Compound subject: int, Interventional
                Compound subject: neuro, Neuroradiology
                Compound subject: vasc, Vascular

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