Late Coil Migration after Embolization of Cerebral Aneurysms – Case Series

Luana Antunes Maranha Gatto; Luana Bandeira Rocha; Gelson Luis Koppe; Zeferino Demartini Jr

doi:10.1055/s-0038-1639347

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, Table of Contents

CC-BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2018; 37(01): 71-75
DOI: 10.1055/s-0038-1639347

Case Report | Relato de Caso

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Late Coil Migration after Embolization of Cerebral Aneurysms – Case Series

Migração tardia de coil após embolização de aneurismas cerebrais - série de casos

Authors

Luana Antunes Maranha Gatto

¹Department of Neurosurgery and Interventional Neuroradiology, Hospital Universitário Cajuru da Pontifícia Universidade Católica (HUC-PUC), Curitiba, PR, Brazil
Luana Bandeira Rocha

²Department of Neurosurgery, HUC-PUC, Curitiba, PR, Brazil
Gelson Luis Koppe

³Department of Interventional Neuroradiology, HUC-PUC, Curitiba, PR, Brazil
Zeferino Demartini Jr

¹Department of Neurosurgery and Interventional Neuroradiology, Hospital Universitário Cajuru da Pontifícia Universidade Católica (HUC-PUC), Curitiba, PR, Brazil

Abstract

Background Coil migration after cerebral aneurysm embolization is a very rare complication. It can take place early or late in the postoperative period, evolving asymptomatic and causing severe neurological deficits. Ruptured aneurysms of anterior communicant artery were the most frequent reported examples in the literature.

Case Report We report three cases of patients with unruptured aneurysms treated with coils and remodeling balloon technique. The first case was that of a left posterior communicating artery aneurysm with coil migration to a distal cortical branch of ipsilateral middle cerebral artery (MCA). The patient had mild paresthesia in the arm for a few days. The second one was a fenestrated basilar artery aneurysm with coil migration to the P2 segment of the left posterior cerebral artery. The patient was fully asymptomatic. The third case was a MCA aneurysm with coil migration to the M3 segment. There were no ischemic complications, and all patients underwent a new endovascular procedure.

Conclusions Coil migration is a rare but not always severe complication. Antiplatelet agents are recommended even if the coil migration is asymptomatic.

Resumo

Introdução A migração de coil após embolização de aneurisma cerebral é uma complicação muito rara. Ela pode ocorrer no período pós-operatório tanto precoce quanto tardio, evoluindo assintomático ou causando graves déficits neurológicos. Aneurismas rotos da artéria comunicador anterior foram os exemplos mais frequentes relatados na literatura.

Relato de Caso Relatamos três casos de pacientes com aneurismas não rotos tratados com coils e técnica de remodelagem com balão. O primeiro caso foi de um aneurisma de artéria comunicante posterior com migração do coil para um ramo cortical distal da artéria cerebral média (ACM) ipsilateral. A paciente apresentou parestesia leve no braço por alguns dias. O segundo foi um aneurisma de artéria basilar fenestrada com migração de coil para o segmento P2 da artéria cerebral posterior esquerda. O paciente ficou totalmente assintomático. O terceiro caso foi de um aneurisma de ACM com migração do coil para o segmento M3. Não houve complicações isquêmicas, e todos os pacientes foram submetidos a novo procedimento endovascular.

Conclusões Migração de coil é uma complicação rara, mas nem sempre grave. Antiagregantes plaquetários são recomendados mesmo se a migração do coil for assintomática.

Keywords

endovascular procedures - interventional radiography - intracranial aneurysm - postoperative complications - intracranial embolism - embolic protection devices

Palavras-chave

procedimentos endovasculares - radiografia - aneurisma intracraniano - complicações pós-operatórias - embolia intracraniana - dispositivos de proteção embólica

Full Text

References

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