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Endovascular retrieval of a dislocated pushable coil in the common hepatic artery using a cerebral stent retriever
Mohammed Shamseldin1, Albrecht Stier2, Norbert Hosten2
1Radiology Department, Helios Klikum Erfurt, Nordhäuser Str. 74, 99089, Erfurt, Germany. drmohammedkam@yahoo.com.
Insights
A dislocated embolic coil from the gastroduodenal artery was successfully retrieved from the common hepatic artery using a pRESET stent retriever, demonstrating its efficacy in abdominal interventions.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Endovascular Therapy
Background:
- Embolization of upper gastrointestinal bleeding (UGIB) using pushable coils can lead to complications.
- Dislocation of coils into adjacent arteries, such as the common hepatic artery (CHA), is a potential risk.
- The gastroduodenal artery (GDA) is a common target for embolization in cases of UGIB.
Purpose of the Study:
- To report the successful retrieval of a dislocated embolic coil from the common hepatic artery (CHA).
- To demonstrate the utility of the pRESET stent retriever for managing coil migration in abdominal vasculature.
- To highlight a novel application of a device primarily used for endovascular stroke treatment.
Main Methods:
- An 88-year-old female patient presented with severe UGIB requiring emergency embolization.
- A pushable coil dislocated into the CHA during GDA embolization, compromising hepatic blood flow.
- A pRESET stent retriever was employed to safely remove the dislodged coil from the CHA.
Main Results:
- The dislocated coil was successfully retrieved from the common hepatic artery without immediate complications.
- Arterial blood flow to the liver was restored after coil removal.
- The procedure avoided potential hepatic ischemia or infarction.
Conclusions:
- The pRESET stent retriever proved highly effective and safe for removing a dislocated coil in the abdominal CHA.
- This case expands the known applications of stent retrievers beyond cerebrovascular interventions.
- This report is the first to document the use of a pRESET stent retriever for dislodged coil retrieval in abdominal vessels.
Background:
This is case of removing a dislocated pushable coil from the common hepatic artery (CHA) as a possible complication of using pushable coils in the embolization of an upper gastrointestinal bleeding (UGIB) from the gastroduodenal artery (GDA) by using a pRESET stent retriever (Phenox, Bochum, Germany) which is utilized mainly for treatment of endovascular stroke.
Case Presentation:
An 88-year-old female patient was referred to our hospital to get an emergency embolization of the GDA causing an UGIB with a relevant drop of the hemoglobin level. During the routine embolization of the GDA using pushable coils, a complete dislocation of the last coil into the CHA took place leading to a relevant slowing down of the arterial blood flow to the liver. A decision was thereby made to remove the dislocated coil to avoid further possible complications which was successfully achieved.
Conclusions:
Various stent retrievers have been proven to be effective in removing dislocated coils during intracerebral coiling of different pathologies. This case report is to our knowledge the first case report proving the high efficacy and safety of using yet another stent retriever, namely a pRESET stent retriever in removing a fully dislocated coil in the abdominal vessels, namely in this case the CHA.
