Symptomatic delayed coil migration after balloon assisted embolization: An underreported adverse event?

Neurocirugia (Astur : Engl Ed). 2019 Mar-Apr;30(2):87-93. doi: 10.1016/j.neucir.2018.02.005. Epub 2018 Apr 3.
[Article in English, Spanish]


Microsurgical clipping is still regarded as the gold-standard treatment for broad-neck intracranial aneurysms. New endovascular techniques like balloon or stent assisted coiling are quickly rising to the challenge and showing promising outcomes. As a result, broad-neck aneurysms are increasingly addressed by these techniques despite they have not been tested against clipping in a randomized controlled trial and long-term complications might be unknown yet. Intraprocedural coil migration has been well documented in the literature, but the same complication in a delayed fashion is scarcely reported. We present a case of delayed coil migration occurring after a balloon-assisted embolization of a wide-necked intracranial aneurysm and we perform a literature review for similar cases. We discuss how, despite seeming an extremely rare complication, with new endovascular techniques increasingly perceived as the safer option in any aneurysm, potential adverse events may become more frequent. Strategies proposed to address this developing scenario are also reviewed.

Keywords: Adverse event; Aneurismas de cuello ancho; Balloon assisted coiling; Broad-neck aneurysm; Coil migration; Embolización asistida por balón; Eventos adversos; Migración de coil; Stent asistido; Stent assisted coiling.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cerebral Arteries / diagnostic imaging*
  • Embolization, Therapeutic / adverse effects*
  • Embolization, Therapeutic / instrumentation*
  • Foreign-Body Migration / diagnostic imaging*
  • Humans
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Time Factors