Department of Neurosurgery, Kushirorousai Hospital, Kushiro, Japan.
Neurosurgery. 2010 Dec;67(2 Suppl Operative):516-21. doi: 10.1227/NEU.0b013e3181f82588.
Balloon-assisted coil placement is an important technique for coil embolization of broad-neck aneurysms. With this technique, we can prevent coil migration into a parent artery during a procedure. Complications of intraprocedural coil migration have been reported in the literature. However, delayed coil migration is extremely rare. We present a case of delayed coil migration after balloon-assisted coil embolization and describe our management of this complication.
A 59-year-old man presented with hypertension and a tension headache. Clinical evaluation incidentally discovered an unruptured broad-neck aneurysm at the left internal carotid bifurcation. Endovascular embolization of the aneurysm was performed with a balloon-assisted technique. The patient had a transient ischemic attack, and a skull radiograph showed coil migration 3 months after the procedure. We performed an operation to remove the coils and to clip the aneurysm with superficial temporal artery and middle cerebral artery bypass. The patient was discharged without neurological deficit.
This is a rare case in which delayed coil migration into the parent artery occurred after balloon-assisted coil embolization, highlighting the importance of surgical management of delayed coil migration.
球囊辅助线圈放置是宽颈动脉瘤线圈栓塞的重要技术。通过这种技术，我们可以防止在手术过程中线圈迁移到母动脉中。文献中已经报道了术中线圈迁移的并发症。然而，延迟的线圈迁移极为罕见。我们报告了一例球囊辅助线圈栓塞后延迟线圈迁移的病例，并描述了我们对这种并发症的处理方法。
一名 59 岁男性因高血压和紧张性头痛就诊。临床评估偶然发现左侧颈内动脉分叉处有一个未破裂的宽颈动脉瘤。采用球囊辅助技术对动脉瘤进行了血管内栓塞。患者出现短暂性脑缺血发作，术后 3 个月颅骨 X 线片显示线圈迁移。我们进行了手术以取出线圈，并使用颞浅动脉和大脑中动脉旁路夹闭动脉瘤。患者出院时无神经功能缺损。
这是一例罕见的球囊辅助线圈栓塞后延迟线圈迁移至母动脉的病例，强调了对延迟线圈迁移进行手术处理的重要性。
