Retrieval of Migrated Coils with Stent Retrievers: An Animal Study |
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| Authors: | O. Nikoubashman R. Pjontek M.-A. Brockmann R. Tolba M. Wiesmann |
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| Affiliation: | aFrom the Department of Neuroradiology (O.N., R.P., M.-A.B., M.W.);bInstitute for Laboratory Animal Science and Experimental Surgery (R.T.), University Hospital Aachen, Aachen, Germany;cMedical Imaging Physics (O.N.), Institute of Neuroscience and Medicine 4, Forschungszentrum Jülich, Jülich, Germany. |
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| Abstract: | BACKGROUND AND PURPOSE:Coil migration is a potentially serious complication of endovascular aneurysm treatment. The aim of the study was to systematically investigate the effectiveness of coil retrieval with a stent retriever in an animal model.MATERIALS AND METHODS:A total of 148 coils of various types and sizes were placed into arteries of varying diameters in a porcine in vivo model. Coil retrieval was performed by placing a Trevo ProVue stent retriever over the coil and trying to trap a part of the platinum coil within the stent mesh by advancing the microcatheter over the stent or simply by retrieving the stent without trying to trap the coil by advancing the microcatheter.RESULTS:Coil retrieval was successful in 101 of 102 cases (99%), in which trapping of the coil within the stent retriever by advancing the microcathter was applied. When we only pulled back the stent without trapping the coil, retrieval was successful in only 5 of 46 cases (11%). Coil type, coil structure (2D versus 3D), actual coil shape in the affected vessel, investigator experience, aspiration, coil localization, and vessel diameter had no significant influence on retrieval outcome. There was no case of vessel perforation.CONCLUSIONS:Retrieval of migrated platinum coils with a stent retriever is an effective treatment option for migrated coils when the correct technique is applied.Brain aneurysms are the most common cause of severe and potentially lethal subarachnoid hemorrhage. Endovascular treatment with detachable coils has become a common option for both ruptured and unruptured cerebral aneurysms, especially if surgery is challenging.1–4 Coil migration is a potentially serious complication of endovascular treatment that has been reported in up to 2%–6% of cases.5,6 Various rescue devices have been suggested for retrieval of migrated platinum coils. However, data in the literature dealing with the effectiveness and complication rates of the respective methods are restricted to a few case reports and small case series.5–7 Our aim was to systematically investigate the effectiveness and complication rates of coil retrieval with a stent retriever in an animal model. |
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