Dislocated Coil of a pseudoaneurysm of the left internal carotid artery

Introduction: Intracranial aneurysm can be treated by coil emobilsation.This is an effectiv and safe procedure.It is known to produce good clinical outcomes and provide sufficient protection against recurrent bleeding.During coil embolisation complications like rupture of aneurysm, arterial dissection,bleeding and microembolic complications can occur.The dislocation of a coil is a rare complication which occur in 2- 6  %  oft he procedures.The dislocated coil can carefully be removed from the aneursym or can be fixed by place the coil back in the aneursym.Case:We present a case of a 61-year-old man with an recurrent undifferentiated epipharynx-carinoma who was represented through the emercency room with unclear nosebleeding.Bleeding was first successfully controlled by insert tamponade.But under sustained bleeding the patient was transfered to a neuroradiolocial departement.An intracranial ruptured aneurysm was detected by magnetic resonance imaging(MRI)and Computed tomography(CT)in the internal carotid artery at the junction of the petrous part to the cavernous part.Endovascular intervention as coiling and endovascular plug embolisation was planned for treatment of this aneurysm.Ten months later the patient described thread material removing of his left nose. It was material of the used coil. A new magnetic resonance imaging(MRI)showed the still correct emobilsation of the internal carotid artery via vascular plug. No intervention was needed.

Conclusion: During endovascular treatment of intracranial aneurysms dislocation oft he coil may occur.This is a serious intraprocedural complication. A protruding coil or a dislocated coil create a thrombogenic focus inside the vessel. The endovascular plug is a useful adjunct,obviating the need for numerous coils and complication.

Conflict of interest

Der Erstautor gibt keinen Interessenskonflikt an.

Publication History

Article published online:
13 May 2021