Doron Omer, Meirowitz Eran, Abergel Eitan
Rambam Health Care Campus, Rappaport Faculty of Medicine, the Technion - Israel Institute of Technology, Haifa, Israel.
J Cerebrovasc Endovasc Neurosurg. 2022 Mar;24(1):58-62. doi: 10.7461/jcen.2021.E2021.03.005. Epub 2021 Nov 2.
Coil migration is a known complication of endovascular coiling of cerebral aneurysms. We report an acute coil migration occurring during coiling of an unruptured anterior choroidal aneurysm, while a separate coil was retrieved into the microcatheter concomitantly without direct contact between the coils. The "pulling" of a previously deployed stable coil is presented as an adverse effect that should be noted. This case exemplifies that not only direct entanglement or erroneous malposition can generate acute migration, but possibly, also alteration of physical forces during coil retrieval. A potential mechanism, similar to a venturi effect, caused by a quick suction within the microcatheter at its distal end, is suggested, and the clinical relevance of the case is discussed.
弹簧圈移位是颅内动脉瘤血管内弹簧圈栓塞术已知的一种并发症。我们报告了1例未破裂脉络膜前动脉瘤栓塞过程中发生的急性弹簧圈移位，同时有1个单独的弹簧圈被回收到微导管内，而这2个弹簧圈之间并无直接接触。先前已放置的稳定弹簧圈发生“牵拉”被视为一种应引起注意的不良效应。该病例表明，不仅直接缠绕或错误的位置不当可导致急性移位，而且在回收弹簧圈过程中物理力的改变也可能导致急性移位。我们提出了一种可能的机制，类似于文丘里效应，是由微导管远端的快速抽吸引起的，并讨论了该病例的临床意义。
