Fonseca Lino, Najarro-Quispe Rafael, Rodríguez-Hernández Ana, Torné Ramon, Gándara-Sabatini Dario, Arikan Fuat, Baños-Carrasco Pilar
Department of Neurological Surgery, Centro Hospitalar Lisboa Central - Hospital São José, Lisbon, Portugal.
Department of Neurological Surgery, Vall d'Hebron University Hospital, Barcelona, Spain.
Neurocirugia (Engl Ed). 2019 Mar-Apr;30(2):87-93. doi: 10.1016/j.neucir.2018.02.005. Epub 2018 Apr 3.
Microsurgical clipping is still regarded as the gold-standard treatment for broad-neck intracranial aneurysms. New endovascular techniques like balloon or stent assisted coiling are quickly rising to the challenge and showing promising outcomes. As a result, broad-neck aneurysms are increasingly addressed by these techniques despite they have not been tested against clipping in a randomized controlled trial and long-term complications might be unknown yet. Intraprocedural coil migration has been well documented in the literature, but the same complication in a delayed fashion is scarcely reported. We present a case of delayed coil migration occurring after a balloon-assisted embolization of a wide-necked intracranial aneurysm and we perform a literature review for similar cases. We discuss how, despite seeming an extremely rare complication, with new endovascular techniques increasingly perceived as the safer option in any aneurysm, potential adverse events may become more frequent. Strategies proposed to address this developing scenario are also reviewed.
