Delayed migration of a self-expanding intracranial microstent

Area of Science:

• Neurosurgery
• Endovascular Therapy
• Cerebrovascular Diseases

Background:

• Endovascular treatment is a common approach for managing intracranial aneurysms.
• Self-expanding intracranial microstents, like the Enterprise stent, are utilized to assist in aneurysm treatment.
• Delayed complications following stent placement require careful monitoring and analysis.

Observation:

• A 43-year-old patient with a basilar apex aneurysm underwent Enterprise stent placement.
• The patient developed vertigo 4 months post-procedure, shortly after discontinuing clopidogrel.
• Follow-up angiography revealed spontaneous migration of the stent into the proximal basilar artery.

Findings:

• This case represents the first documented instance of spontaneous, delayed migration of a self-expanding intracranial microstent.
• The migration occurred months after the initial stent placement.
• The exact cause of spontaneous migration remains unclear but may be multifactorial.

Implications:

• This event underscores the importance of long-term surveillance after endovascular stent placement for intracranial aneurysms.
• Understanding the mechanisms of stent migration is crucial for improving device design and patient selection.
• Further research is needed to elucidate the risk factors and management strategies for delayed stent migration.