Mehta Neel H, Klinger Neil, Luiselli Gabrielle, Aziz-Sultan Mohammad A, Dafford Kurtus, Zaidi Hasan
Department of Neurosurgery, Massachusetts General Hospital, Boston, USA.
Department of Neurosurgery, Brigham and Women's Hospital, Boston, USA.
Cureus. 2025 Jul 18;17(7):e88262. doi: 10.7759/cureus.88262. eCollection 2025 Jul.
Abdominal aortic aneurysms (AAAs) require complex surgical management. Currently, endovascular aneurysm repair (EVAR), including the placement of stent grafts and endovascular coils, offers early survival benefits over open surgery but carries its own distinct set of complications. We report the case of a 68-year-old man with a 35-mm saccular AAA who initially underwent stent graft placement and later required additional endovascular treatment for a type 2 endoleak. Intraoperatively, part of the coil mass appeared to deviate from the expected contour of the aneurysm. Postoperative CT imaging revealed migration of the endovascular coils into the lumbar epidural space. To our knowledge, this is the first reported case of coil migration into the lumbar spinal canal following EVAR for an AAA. The patient developed progressive symptoms of lumbar stenosis and radiculopathy, ultimately requiring decompression, fusion, and removal of the migrated coils. This report presents a novel postoperative complication and underscores the importance of careful surgical planning, interdisciplinary collaboration among surgical subspecialists, and thorough clinical and radiographic follow-up.
腹主动脉瘤（AAAs）需要复杂的手术治疗。目前，血管内动脉瘤修复术（EVAR），包括放置支架移植物和血管内栓塞弹簧圈，与开放手术相比，能提高早期生存率，但也有其独特的一系列并发症。我们报告一例68岁男性患者，患有35毫米囊状腹主动脉瘤，最初接受了支架移植物置入术，后来因2型内漏需要额外的血管内治疗。术中，部分弹簧圈团块似乎偏离了动脉瘤的预期轮廓。术后CT成像显示血管内弹簧圈迁移至腰段硬膜外间隙。据我们所知，这是首例报道的腹主动脉瘤血管内修复术后弹簧圈迁移至腰椎管的病例。患者出现了腰椎管狭窄和神经根病的进行性症状，最终需要进行减压、融合以及取出迁移的弹簧圈。本报告介绍了一种新的术后并发症，并强调了仔细的手术规划、外科亚专业之间的跨学科协作以及全面的临床和影像学随访的重要性。
