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BMJ Case Rep ; 17(1)2024 Jan 18.
Article in English | MEDLINE | ID: mdl-38238159

ABSTRACT

We report a case of a patient who initially presented with a subarachnoid haemorrhage secondary to a ruptured supraclinoid internal carotid artery (ICA) blister aneurysm. The patient was treated successfully with a flow diverter stent (FD) and coiling; however, a large aneurysm recurrence via a feeding posterior communicating artery (PCOM) was noted on the 1-year follow-up angiogram. During the retreatment, a second FD in the ICA resulted in insufficient aneurysm stasis. Therefore, the decision was made to coil sacrifice the PCOM via posterior circulation access. During the first coil deployment, the distal coil end migrated through the mesh of two overlapping FD into the middle cerebral artery. This complication was a previously unrecognised possibility given the composition of the FD. This case report aims to discuss this process as a potential complication during neurointerventional procedures using these devices.


Subject(s)
Aneurysm, Ruptured , Carotid Artery Diseases , Embolization, Therapeutic , Endovascular Procedures , Intracranial Aneurysm , Humans , Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/surgery , Embolization, Therapeutic/methods , Carotid Artery, Internal/diagnostic imaging , Carotid Artery Diseases/complications , Stents/adverse effects , Aneurysm, Ruptured/diagnostic imaging , Aneurysm, Ruptured/surgery , Cerebral Angiography , Retrospective Studies
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