title: Middle cerebral artery aneurysm surgery after stent misplacement: A case report.
abstract: Stent misplacement during endovascular treatment of middle cerebral artery (MCA) aneurysms can cause challenges and be problematic, if clipping becomes necessary. This article reports on a 56-year-old woman with an unruptured, multi-lobulated MCA aneurysm, whom primarily refused surgery; therefore, she was scheduled for stent-assisted coiling. After successful deployment of the stent, it unfortunately then became snagged by the microcatheter and was pulled backwards. The subsequent surgical procedure (i.e. clipping of the MCA aneurysm) was challenging, due to the position of the dislodged stent. Such as misplacement of the stent is rarely documented: It resulted in the difficult handling of a MCA aneurysm. Aneurysms of the MCA should primarily be considered for surgical clipping. In conclusion, an increased risk for eventual surgery should be considered, in cases where endovascular treatments with stents are performed.
authors.affiliation: Department of Neurosurgery, Paracelsus Medical University Salzburg, Salzburg, Austria a.al-schameri@salk.at.
authors.forename: Abdul Rahman
authors.initials: AR
authors.lastname: Al-Schameri
authors.affiliation: Department of Neurosurgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Manuel
authors.initials: M
authors.lastname: Lunzer
authors.affiliation: Department of Neurosurgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Daller
authors.affiliation: Department of Neurosurgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Kral
authors.affiliation: Research Institute of Neurointervention, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Monika
authors.initials: M
authors.lastname: Killer
mesh_terms: D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D020197:Head Injuries, Penetrating / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019300:Medical Errors / Q000009:adverse effects* / Q000517:prevention & control; D008875:Middle Aged; D011859:Radiography; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Adverse effects; aneurysm; case study; middle cerebral artery; stent misplacement; stent-assisted coiling; surgical clipping