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Related Experiment Video

Updated: Jul 5, 2025

Experimental Investigation of Secondary Flow Structures Downstream of a Model Type IV Stent Failure in a 180° Curved Artery Test Section
11:00

Experimental Investigation of Secondary Flow Structures Downstream of a Model Type IV Stent Failure in a 180° Curved Artery Test Section

Published on: July 19, 2016

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Coil migration through two flow-diverting stents.

Patrick Scott Rogers1, David Volders2, Gwynedd Pickett3

  • 1Diagnostic Imaging, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada pt319294@dal.ca.

BMJ Case Reports
|January 18, 2024
PubMed
Summary

A rare complication occurred during retreatment of a recurrent internal carotid artery (ICA) blister aneurysm. Coil migration through overlapping flow diverter stents into the middle cerebral artery highlights a previously unrecognized risk in neurointerventional procedures.

Keywords:
Interventional radiologyNeuroimagingNeurologyRadiology

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Last Updated: Jul 5, 2025

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Area of Science:

  • Neurosurgery
  • Interventional Neuroradiology
  • Vascular Neurology

Background:

  • Subarachnoid hemorrhage (SAH) due to supraclinoid internal carotid artery (ICA) blister aneurysms requires effective treatment.
  • Flow diverter stents (FDs) and coiling are established treatments for complex aneurysms.
  • Recurrence necessitates careful consideration of retreatment strategies.

Observation:

  • A patient treated for a ruptured ICA blister aneurysm experienced recurrence via a posterior communicating artery (PCOM) 1 year post-treatment.
  • Retreatment with a second FD in the ICA provided insufficient aneurysm stasis.
  • Coil sacrifice of the PCOM via posterior circulation access was attempted.

Findings:

  • During coil deployment for PCOM sacrifice, distal coil migration occurred through the mesh of two overlapping FDs.
  • The migrated coil entered the middle cerebral artery, a complication attributed to the FD composition.
  • This represents a previously unrecognized complication of overlapping FDs in neurointerventional procedures.

Implications:

  • This case highlights a novel complication associated with overlapping flow diverter stents.
  • Neurointerventionalists must be aware of potential coil migration through FD mesh.
  • Understanding FD material properties is crucial for preventing such adverse events during aneurysm treatment.