Manual Aspiration Technique to Retrieve a Prematurely Detached Coil during Cerebral Aneurysm Embolization

Neurointervention 2014³â 9±Ç 1È£ p.21 ~ p.25

(Stidd David A.) - USA Rush University Medical Center Department of Neurosurgery
(Johnson Andrew K.) - USA Rush University Medical Center Department of Neurosurgery
(Lopes Demetrius K) - USA Rush University Medical Center Department of Neurosurgery

Abstract

Coil herniation, premature deployment, and fracture are procedure associated complications of endovascular aneurysm embolization that optimally necessitate coil retrieval when feasible. Several published techniques describe different strategies for managing coil complications including various snare retrieval devices, alligator retrieval devices, stent fixation, and open surgical resection of coils when distal blood flow is compromised. We report a novel technique employed to retrieve a prematurely detached coil during an aneurysm embolization using a syringe fixed to the microcatheter to carefully aspirate a loose coil with direct fluoroscopic visualization. This technique can only be utilized in the circumstance where the proximal end of the coil remains in the microcatheter. Conventional techniques of coil retrieval and stenting are discussed and compared to the rational for using the manual aspiration technique.

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Cerebral aneuryusms, Endovascular procedures/complication, Embolization, therapeutic
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