Novel balloon application for rescue and realignment of a proximal end migrated pipeline flex embolization device into the aneurysmal sac: complication management

BMJ Case Rep. 2016 Mar 23;2016:bcr2016012263. doi: 10.1136/bcr-2016-012263.

Abstract

The pipeline embolization device (PED) has become a routine firstline option for the treatment of an increasing population of intracranial aneurysms at many neurovascular centers. Intraprocedural complications during PED deployment, or complications associated with migration of the device, are rarely reported problems. Significant mismatch in luminal diameter between the inflow vessel and the outflow vessel or excessive dragging-stretching of the PED have been related to 'watermelon seed' or 'accordion' effects, respectively, resulting in stent migration. Here we present a novel balloon technique that was successfully used to realign an in situ flow diverting stent that had prolapsed into a large aneurysm. This represents a useful salvage technique and should be considered when encountering this potential complication.

Keywords: Aneurysm; Flow Diverter.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon / methods*
  • Embolization, Therapeutic / adverse effects*
  • Embolization, Therapeutic / instrumentation
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy*
  • Middle Aged
  • Stents
  • Treatment Outcome