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Coil migration during or after endovascular coiling of cerebral aneurysms.
Abdalkader, Mohamad; Piotin, Michel; Chen, Michael; Ortega-Gutierrez, Santiago; Samaniego, Edgar; Weill, Alain; Norbash, Alexander M; Nguyen, Thanh N.
Afiliação
  • Abdalkader M; Radiology, Boston University School of Medicine, Boston, Massachusetts, USA mohamad.abdalkader@bmc.org.
  • Piotin M; Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France.
  • Chen M; Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.
  • Ortega-Gutierrez S; Neurology, Radiology and Neurosurgery, University of Iowa, Iowa City, Iowa, USA.
  • Samaniego E; Neurology, Radiology and Neurosurgery, University of Iowa, Iowa City, Iowa, USA.
  • Weill A; Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada.
  • Norbash AM; Radiology, University of California San Diego, San Diego, California, USA.
  • Nguyen TN; Neurology, Radiology and Neurosurgery, Boston University School of Medicine, Boston, Massachusetts, USA.
J Neurointerv Surg ; 12(5): 505-511, 2020 May.
Article em En | MEDLINE | ID: mdl-31662464
BACKGROUND: Coil migration is a complication of endovascular coiling of cerebral aneurysms that has not been well studied. OBJECTIVE: To report the frequency, risk factors, management strategies, and outcomes of coil migration. METHODS: This was a retrospective analysis of the clinical and radiological data of patients who underwent cerebral aneurysm coiling complicated by coil migration at five neuroendovascular centers in the United States, Canada, and France between 2008 and 2018. RESULTS: Eighteen cases of coil migration met our study criteria with an occurrence of 0.3% (18/6071 cases) (procedural migration: 55%, delayed migration: 45%). The mean aneurysm maximal diameter, neck, and height to neck ratio in migration cases were 3.4±1.4 mm (range 2-7.6 mm), 2.4±0.9 mm (range 1.2-4.4 mm), and 1.4±0.4 (range 1-2.15), respectively. The 2 mm diameter coil was the most common (39%, range 1-2.5 mm) migrated coil. The length of the migrated coil was ≤4 cm in 95% of cases.Patients managed conservatively (5/18, 28%) did well. Thromboembolic and/or hemorrhagic complications were noted in 6/10 migration patients treated by endovascular modalities and in all migration patients who underwent surgical treatment (4/4). Three deaths occurred (3/18, 17%) related to high Hunt and Hess grade subarachnoid hemorrhage. CONCLUSION: Coil migration is an uncommon but important complication of cerebral aneurysm coiling. Small aneurysms, aspect ratio <1.6, and small coils are significant risk factors. Endovascular treatment, such as using a stent retriever, can be considered for procedural, proximal migration, and/or in cases of vessel occlusion. Delayed or distal migration should be managed conservatively.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Aneurisma Intracraniano / Migração de Corpo Estranho / Procedimentos Endovasculares Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do norte / Europa Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Aneurisma Intracraniano / Migração de Corpo Estranho / Procedimentos Endovasculares Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do norte / Europa Idioma: En Ano de publicação: 2020 Tipo de documento: Article