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Updated: Jan 24, 2026
18:50
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
14.0K
A rare complication of flow diverter: delayed migration causing aneurysm expansion and brainstem compression
Youssef El Ouadih1, Guillaume Coll1, Betty Jean1
1Service de Neurochirurgie, CHU Gabriel Montpied, Clermont-Ferrand, France.
British Journal of Neurosurgery
|May 28, 2019
Summary
Delayed migration of flow-diverting stents (FD) can cause brainstem compression. This case highlights the risk of pipeline embolization device (PED) migration, emphasizing surgical intervention for vascular compression emergencies.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Medical Device Technology
Background:
- Flow-diverting stents (FD) are established treatments for complex aneurysms.
- Delayed migration of FDs is rare but can lead to severe complications.
- Brainstem compression is an exceptional consequence of FD migration.
Observation:
- A case of delayed migration of a pipeline embolization device (PED) is presented.
- The migrated PED caused compression of the medulla oblongata.
- This compression resulted from the expansion of a posterior inferior cerebellar artery (PICA) aneurysm.
Findings:
- This is the first reported instance of brainstem compression due to delayed FD migration.
- Two of seven previously reported delayed FD migration cases were fatal.
- Technical aspects of stenting and surgical management are critical for vascular compression.
Implications:
- Highlights a rare but potentially fatal delayed complication of FD use.
- Underscores the importance of surgical intervention in emergent vascular compression.
- Suggests increased vigilance is needed as FD utilization expands.
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