title: A surgical case of delayed coil migration after balloon-assisted embolization of an intracranial broad-neck aneurysm: case report.
abstract: BACKGROUND
  Balloon-assisted coil placement is an important technique for coil embolization of broad-neck aneurysms. With this technique, we can prevent coil migration into a parent artery during a procedure. Complications of intraprocedural coil migration have been reported in the literature. However, delayed coil migration is extremely rare. We present a case of delayed coil migration after balloon-assisted coil embolization and describe our management of this complication.
  
  
  METHODS
  A 59-year-old man presented with hypertension and a tension headache. Clinical evaluation incidentally discovered an unruptured broad-neck aneurysm at the left internal carotid bifurcation. Endovascular embolization of the aneurysm was performed with a balloon-assisted technique. The patient had a transient ischemic attack, and a skull radiograph showed coil migration 3 months after the procedure. We performed an operation to remove the coils and to clip the aneurysm with superficial temporal artery and middle cerebral artery bypass. The patient was discharged without neurological deficit.
  
  
  CONCLUSIONS
  This is a rare case in which delayed coil migration into the parent artery occurred after balloon-assisted coil embolization, highlighting the importance of surgical management of delayed coil migration.
authors.affiliation: Department of Neurosurgery, Kushirorousai Hospital, Kushiro, Japan. moccihiro@yahoo.co.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Motegi
authors.forename: Masanori
authors.initials: M
authors.lastname: Isobe
authors.forename: Toyohiko
authors.initials: T
authors.lastname: Isu
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kamiyama
mesh_terms: D021721:Balloon Occlusion / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004868:Equipment Failure; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography