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      A coil in the hair—a case report of percutaneous coil migration

      case-report

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          Abstract

          Coil migration following cerebral aneurysm treatment has been described and may result in stroke, recurrent aneurysm, or local mass effect. Cerebral coil embolization is also applied in arteriovenous malformations and arteriovenous fistulas, but these pathologies are relatively rare and coil migration is not as well described. Furthermore, these cases are more commonly treated with combinations of multiple modalities to achieve cure. Embolization, surgery, and radiation each have risks and benefits and combinations may have synergistic risks and benefits not seen in monotherapy. We report a case of extravascular and extra-corporeal coil migration after embolization and craniectomy to treat a patient with hemorrhage from an arteriovenous fistula.

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          The online version of this article (10.1007/s00701-018-3689-3) contains supplementary material, which is available to authorized users.

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          Most cited references5

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          Combined surgical and endovascular treatment of complex cerebrovascular diseases in the hybrid operating room

          Yuichi Murayama, Hideki Arakawa, Toshihiro Ishibashi … (2013)
          Article 0 comments Cited 25 times – based on 0 reviews     Review now
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            Microsurgical management of incompletely coiled and recurrent aneurysms: trends, techniques, and observations on coil extrusion.

            Michael Lawton, M. Halbach, J Waldron (2009)
            With the growing volume of aneurysms treated with endovascular methods and the unavoidable risks of incomplete coiling or recurrence, the volume of coiled aneurysms requiring surgical management is growing. We present a consecutive surgical experience with previously coiled aneurysms to examine clinical trends, the phenomenon of coil extrusion, microsurgical techniques, and morphological features affecting clippability. During a 10-year period, 43 patients underwent surgical management of an incompletely coiled or recurrent aneurysm (Gurian group B). Most patients (88%) presented initially with subarachnoid hemorrhage, most commonly (28%) located in the anterior communicating artery, and 42% of aneurysms were large or giant sized. Twenty-one patients had incompletely coiled aneurysms and 22 patients had recurrent aneurysms, with a mean time to recurrence of 28 months. Coil extrusion was observed in 1 of the incompletely coiled (5%) and 12 of the recurrent aneurysms (55%). Overall, 33 aneurysms were clipped directly, 7 unclippable aneurysms were bypassed, and 3 were wrapped. Three patients died (surgical mortality, 7%), 1 patient (2%) experienced permanent neurological morbidity, and the remaining 39 patients (91%) had good outcomes (mean follow-up, 4.3 years). This study demonstrated a sharp increase in the incidence of coiled aneurysms requiring surgery, reflecting the increasing numbers of patients opting for endovascular therapy initially. Coil extrusion occurs more often than expected, is often misdiagnosed on angiography as simply compaction, and seems to be a time-dependent process not seen acutely. Direct clipping is the preferred microsurgical treatment of coiled aneurysms and may be predicted by the relationship between coil width and compaction height (C/H < 2.5, or a wedge angle < 90 degrees). We recommend a bypass strategy for unclippable coiled aneurysms because it can be executed methodically; has predictable ischemia times; and is associated with more favorable results than thrombectomy, coil extraction, and clip reconstruction.
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              Refinement of the Hybrid Neuroendovascular Operating Suite: Current and Future Applications.

              Ramsey Ashour, Alfred See, Hormuzdiyar H Dasenbrock … (2016)
              In early-generation hybrid biplane endovascular operating rooms, switching from surgical to angiographic position is cumbersome. In this report, we highlight the unique design of a new hybrid neuroendovascular operating suite that allows surgical access to the head while keeping the biplane system over the lower body of the patient. Current and future hybrid neuroendovascular operating suite applications are discussed.
              Article 0 comments Cited 5 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Marike L. D. Broekman:
                ORCID: http://orcid.org/0000-0003-2205-5179
                +31-887557059 , M.L.D.Broekman-4@umcutrecht.nl
                Journal
                Journal ID (nlm-ta): Acta Neurochir (Wien)
                Journal ID (iso-abbrev): Acta Neurochir (Wien)
                Title: Acta Neurochirurgica
                Publisher: Springer Vienna (Vienna )
                ISSN (Print): 0001-6268
                ISSN (Electronic): 0942-0940
                Publication date (Electronic): 3 October 2018
                Publication date PMC-release: 3 October 2018
                Publication date (Print): 2018
                Volume: 160
                Issue: 12
                Pages: 2397-2399
                Affiliations
                [1 ]ISNI 0000000090126352, GRID grid.7692.a, Department of Neurosurgery, Brain Center Rudolf Magnus, , University Medical Center Utrecht, ; HP G03.124, PO Box 85500, 3508 GA Utrecht, The Netherlands
                [2 ]ISNI 0000 0004 0378 8294, GRID grid.62560.37, Department of Neurosurgery, , Brigham and Women’s Hospital, ; Boston, MA 02115 USA
                [3 ]ISNI 0000 0004 1784 5501, GRID grid.414405.0, Department of Radiology, Instituto delle Scienze Neurologiche di Bologna, , Ospedale Bellaria, ; Bologna, Italy
                Author information
                http://orcid.org/0000-0003-2205-5179
                Article
                Publisher ID: 3689
                DOI: 10.1007/s00701-018-3689-3
                PMC ID: 6267699
                PubMed ID: 30284020
                SO-VID: 5a0f5c8d-bae7-4ab4-a72e-c3dcb09c258a
                Copyright © © The Author(s) 2018
                License:

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Date received : 2 June 2018
                Date accepted : 21 September 2018
                Funding
                Funded by: University Medical Center Utrecht
                Categories
                Subject: Case Report - Vascular Neurosurgery - Other
                Custom metadata
                issue-copyright-statement © Springer-Verlag GmbH Austria, part of Springer Nature 2018

                ScienceOpen disciplines: Surgery
                Keywords: foreign body migration,therapeutic embolization,craniotomy,intracranial arteriovenous malformations,cerebral hemorrhage
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: foreign body migration, therapeutic embolization, craniotomy, intracranial arteriovenous malformations, cerebral hemorrhage

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