Parent vessel Guglielmi detachable coil herniation during wide-necked aneurysm embolization: treatment with intracranial stent placement: two technical case reports.
OBJECTIVE
Despite recent advances in technology, parent vessel coil herniation occasionally complicates successful Guglielmi detachable coil embolization, particularly in wide-necked aneurysms. We report endovascular stent deployment performed in two patients specifically to treat this complication.


METHODS
Two patients underwent Guglielmi detachable coil embolization of cavernous segment aneurysms. Both developed coil herniation into the internal carotid artery. In one patient, the herniation occurred during the initial procedure; in the other, it was discovered in a delayed fashion during a follow-up examination for ocular symptoms.


METHODS
In both patients, endovascular stent deployment was performed to isolate the herniated portion of the coil from the internal carotid lumen. Follow-up angiography at 6 months demonstrated no aneurysm recanalization and no stenosis of the parent internal carotid artery in the stented region in either patient.


CONCLUSIONS
The use of intraluminal stents has been reported to be a helpful technical adjunct to the conventional endovascular treatment of aneurysms and balloon angioplasty. One additional indication for the use of this technology is sequestering herniated coils from the lumen of the parent artery to reduce potential embolic or occlusive sequelae.
Lavine
S D
SD
Department of Neurological Surgery, University of Southern California School of Medicine, Los Angeles 90033, USA.
Larsen
D W
DW
Giannotta
S L
SL
Teitelbaum
G P
GP
D015901:Angiography, Digital Subtraction; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019233:Retreatment; D015607:Stents