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Snare technique for endovascular retrieval of coil extending to the atrium after embolization of a dural arteriovenous fistula

  • Technical Note - Vascular Neurosurgery - Other
  • Published:
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Abstract

Background

No data exist regarding retrieval of displaced or stretched coil extending to the right atrium after endovascular embolization of cerebrovascular diseases. We describe a snare technique for retrieval of a displaced coil extending to the right atrium after embolization of dural arteriovenous fistula (DAVF).

Methods

A 35-year-old female with a DAVF underwent transjugular coil embolization that failed with displaced coil extending to the right atrium at an outside hospital. After admission to our hospital, Onyx embolization of the DAVF was performed through left facial vein–inner canthus vein–superior ophthalmic vein to the cavernous sinus. Post-embolization angiography showed complete occlusion of the DAVF. Then we attempted to snare the tip of the displaced coil that extended to the right atrium through femoral vein–inferior vena cava approach. However, current snare techniques failed to retrieve the extended coil after several attempts. Then one week later, we used a modified dual microcatheter and microwire technique to retrieve the displaced coil. One suite of microcatheter and microwire was used to produce a handmade snare device (HMD). The other suite of microcatheter and microwire was used to assist the HMD to snare the displaced coil.

Results

Through transjugular vein approach, we used our modified dual microcatheter and microwire snare technique (handmade snare device system) to retrieve the extended coil. After several attempts, the extended coil in the atrium was successfully retrieved. Post-procedure angiography and cardiac examinations did not show any signs of abnormality.

Conclusions

For displaced coil extending to the right atrium after transvenous embolization, our method of modified dual microcatheter technique with HMD snare device system is an effective method to retrieve the extending coil.

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Abbreviations

DAVF:

Dural arteriovenous fistula

DSA:

Digital subtraction angiography

HMD:

Handmade snare device

MRI:

Magnetic resonance imaging

References

  1. Chen Z, Tang W, Feng H, Zhu G (2009) Surgical extraction of migrated coils via proximal segment of the anterior cerebral artery: an emergency alternative. Neurol India 57:327–330

    Article  Google Scholar 

  2. Dinc H, Kuzeyli K, Kosucu P, Sari A, Cekirge S (2006) Retrieval of prolapsed coils during endovascular treatment of cerebral aneurysms. Neuroradiology 48:269–272

    Article  Google Scholar 

  3. Fiorella D, Albuquerque FC, Deshmukh VR, McDougall CG (2005) Monorail snare technique for the recovery of stretched platinum coils: technical case report. Neurosurgery 57(1 Suppl):E210

    PubMed  Google Scholar 

  4. Graves VB, Rappe AH, Smith TP, Sepetka I, Ahuja A, Strother CM (1993) An endovascular retrieving device for use in small vessels. AJNR Am J Neuroradiol 14:804–808

    CAS  PubMed  Google Scholar 

  5. He C, Chen J, Hussain M, Ding Y, Zhang H (2016) Retrieval of a migrated coil with a handmade microwire-snare device. Acta Neurochir 158:1539–1543

    Article  Google Scholar 

  6. Henkes H, Lowens S, Preiss H, Reinartz J, Miloslavski E, Kühne D (2006) A new device for endovascular coil retrieval from intracranial vessels: alligator retrieval device. AJNR Am J Neuroradiol 27:327–329

    CAS  PubMed  Google Scholar 

  7. Hopf-Jensen S, Hensler HM, Preiß M, Müller-Hülsbeck S (2013) Solitaire® stent for endovascular coil retrieval. J Clin Neurosci 20:884–886

    Article  CAS  Google Scholar 

  8. Janjua N, Bulic S, Tan BC, Panichpisal K, Miller J (2014) Salvage of distal non-target coil embolization with stent placement and intravenous eptifibatide in a ruptured, unsecured, atypical aneurysm. J Neurointerv Surg 6:E21

    Article  Google Scholar 

  9. Kim YB, Lee KC, Lee JW, Huh SK, Yoon PH, Kim DI (2009) Rescue microsurgery in coil herniation causing thromboembolic occlusion of parent artery. Acta Neurochir 151:1609–1616

    Article  Google Scholar 

  10. Koseoglu K, Parildar M, Oran I, Memis A (2004) Retrieval of intravascular foreign bodies with goose neck snare. Eur J Radiol 49:281–285

    Article  Google Scholar 

  11. Lee CY (2011) Use of wire as a snare for endovascular retrieval of displaced or stretched coils: rescue from a technical complication. Neuroradiology 53:31–35

    Article  Google Scholar 

  12. Leslie-Mazwi TM, Heddier M, Nordmeyer H, Stauder M, Velasco A, Mosimann PJ, Chapot R (2013) Stent retriever use for retrieval of displaced microcoils: a consecutive case series. AJNR Am J Neuroradiol 34:1996–1999

    Article  CAS  Google Scholar 

  13. Luo CB, Chang FC, Teng MM, Guo WY, Chang CY (2008) Stent management of coil herniation in embolization of internal carotid aneurysms. AJNR Am J Neuroradiol 29:1951–1955

    Article  Google Scholar 

  14. O’Hare AM, Rogopoulos AM, Stracke PC, Chapot RG (2010) Retrieval of displaced coil using a solitaire® stent. Clin Neuroradiol 20:251–254

    Article  Google Scholar 

  15. Prestigiacomo CJ, Fidlow K, Pile-Spellman J (1999) Retrieval of a fractured Guglielmi detachable coil with use of the goose neck snare “twist” technique. J Vasc Interv Radiol 10:1243–1247

    Article  CAS  Google Scholar 

  16. Raftopoulos C, Goffette P, Billa RF, Mathurin P (2002) Transvascular coil hooking procedure to retrieve an unraveled Guglielmi detachable coil: technical note. Neurosurgery 50:912–914

    Article  Google Scholar 

  17. Schütz A, Solymosi L, Vince GH, Bendszus M (2005) Proximal stent fixation of fractured coils: technical note. Neuroradiology 47:874–878

    Article  Google Scholar 

  18. Shin YS, Lee KC, Kim DI, Lee KS, Huh SK (2000) Emergency surgical recanalisation of A1 segment occluded by a Guglielmi detachable coil. J Clin Neurosci 7:259–262

    Article  CAS  Google Scholar 

  19. Smith TP, Graves VB, Halbach VV, Higashida RT, Fraser KW, Dowd CF, Hieshima GB (1993) Microcatheter retrieval device for intravascular foreign body removal. AJNR Am J Neuroradiol 14:809–811

    CAS  PubMed  Google Scholar 

  20. Standard SC, Chavis TD, Wakhloo AK, Ahuja A, Guterman LR, Hopkins LN (1994) Retrieval of a Guglielmi detachable coil after unraveling and fracture: case report and experimental results. Neurosurgery 35:994–999

    Article  CAS  Google Scholar 

  21. Thornton J, Dovey Z, Alazzaz A, Misra M, Aletich VA, Debrun GM et al (2000) Surgery following endovascular coiling of intracranial aneurysms. Surg Neurol 54:352–360

    Article  CAS  Google Scholar 

  22. Vora N, Thomas A, Germanwala A, Jovin T, Horowitz M (2008) Retrieval of a displaced detachable coil and intracranial stent with an L5 Merci Retriever during endovascular embolization of an intracranial aneurysm. J Neuroimaging 18:81–84

    Article  Google Scholar 

  23. Watanabe A, Hirano K, Mizukawa K, Kamada M, Okamura H, Suzuki Y, Ishii R (1995) Retrieval of a migrated detachable coil — case report. Neurol Med Chir (Tokyo) 35:247–250

    Article  CAS  Google Scholar 

  24. Zoarski GH, Bear HM, Clouston JC, Ragheb J (1997) Endovascular extraction of malpositioned fibered platinum microcoils from the aneurysm sac during endovascular therapy. AJNR Am J Neuroradiol 18:691–695

    CAS  PubMed  Google Scholar 

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Acknowledgements

Thanks to the dedicated work of the neurointerventional group of Xuanwu Hospital, Capital Medical University.

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Authors and Affiliations

  1. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China International Neuroscience Institute (China-INI), Beijing, China

    Xianzeng Tong, Peng Hu, Tao Hong, Meng Li, Peng Zhang & Hongqi Zhang

  2. Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China

    Kunyang Bao

Authors
  1. Xianzeng Tong
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  2. Kunyang Bao
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  3. Peng Hu
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  4. Tao Hong
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  5. Meng Li
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  6. Peng Zhang
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  7. Hongqi Zhang
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Corresponding author

Correspondence to Peng Zhang.

Ethics declarations

This study was approved by the Institutional Review Board of Xuanwu Hospital, Capital Medical University.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study is a retrospective study. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from the patient and her relatives.

Additional information

This article is part of the Topical Collection on Vascular Neurosurgery - Other

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Tong, X., Bao, K., Hu, P. et al. Snare technique for endovascular retrieval of coil extending to the atrium after embolization of a dural arteriovenous fistula. Acta Neurochir 160, 2177–2186 (2018). https://doi.org/10.1007/s00701-018-3667-9

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  • DOI: https://doi.org/10.1007/s00701-018-3667-9

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