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Erschienen in:
01.06.2016 | Clinical Article - Vascular
Retrieval of a migrated coil with a handmade microwire-snare device
Erschienen in: Acta Neurochirurgica | Ausgabe 8/2016
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Background
Intraprocedural coil migration during endovascular treatment of intracranial aneurysms is associated with potential vessel occlusion and thromboembolic complications. There is no standard management strategy for coil migration. Here, we describe our experience with using a handmade microwire-snare device (HMD) to retrieve a migrated coil.
Methods
The HMD consists of a 0.017-inch microcatheter, a 0.014-inch microwire, and a 4-0 silk thread. The ring of the microwire-snare device can open, close, and twist in a figure eight pattern for coil entwinement. In addition, the ring can be shaped as needed to navigate tortuous vessels or capture the migrated coil.
Results
The HMD was successfully used to retrieve two migrated coils. In the first case, the coil was displaced in the M2 branch of the middle cerebral artery. In the second case, the coil loop prolapsed into the parent artery. In both cases, control cerebral angiograms performed after retrieval confirmed the patency of the vessels and a lack of thromboembolic complications. At the 3-month follow-up, magnetic resonance angiography demonstrated stable patency of the affected vessels.
Conclusions
The HMD is a cost-effective, easy-to-use, safe, and universally available device for retrieving migrated coil(s) during intracranial aneurysm embolization procedures.