Herniated Proximal Marker of the Stent into the Meningohypophyseal Trunk after Stent-Assisted Coil Embolization for Intracranial Aneurysms

The SolitaireTM AB Neurovascular Remodeling Device (ev3, Irvine, CA, USA) is used to retain coils within an aneurysm, reducing the risk of embolic complications from coil herniation into the parent artery. Stents are deployed after confirming the optimal position of the stent markers across the aneu...

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Main Author: Won-Bae Seung
Format: Article
Language:English
Published: Karger Publishers 2018-08-01
Series:Case Reports in Neurology
Subjects:
Online Access:https://www.karger.com/Article/FullText/492110
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author Won-Bae Seung
author_facet Won-Bae Seung
author_sort Won-Bae Seung
collection DOAJ
description The SolitaireTM AB Neurovascular Remodeling Device (ev3, Irvine, CA, USA) is used to retain coils within an aneurysm, reducing the risk of embolic complications from coil herniation into the parent artery. Stents are deployed after confirming the optimal position of the stent markers across the aneurysm to avoid entry into perforators or branching arteries. Stent marker position is very important to prevent perforating or branching artery infarction. We performed stent-assisted coil embolization using the Solitaire AB stent to treat 2 aneurysms simultaneously. After successful coil embolization, we detached the Solitaire stent in the usual manner. However, the proximal stent marker, which was located at the horizontal segment of the cavernous internal carotid artery, moved into the meningohypophyseal trunk and occluded it. Although the distal markers were positioned optimally, we did not expect the proximal marker to be in the position where it was located. Fortunately, cranial nerve dysfunctions and pituitary deficiency did not develop. It is important to prevent ischemic injury by occlusion of the perforators or branching vessels that can be caused by malpositioned stent markers. We consider where the proximal marker of the stent might be located after detachment.
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spelling doaj.art-20912c4de9554584a82fbbab387ae8392022-12-22T00:33:17ZengKarger PublishersCase Reports in Neurology1662-680X2018-08-0110221321610.1159/000492110492110Herniated Proximal Marker of the Stent into the Meningohypophyseal Trunk after Stent-Assisted Coil Embolization for Intracranial AneurysmsWon-Bae SeungThe SolitaireTM AB Neurovascular Remodeling Device (ev3, Irvine, CA, USA) is used to retain coils within an aneurysm, reducing the risk of embolic complications from coil herniation into the parent artery. Stents are deployed after confirming the optimal position of the stent markers across the aneurysm to avoid entry into perforators or branching arteries. Stent marker position is very important to prevent perforating or branching artery infarction. We performed stent-assisted coil embolization using the Solitaire AB stent to treat 2 aneurysms simultaneously. After successful coil embolization, we detached the Solitaire stent in the usual manner. However, the proximal stent marker, which was located at the horizontal segment of the cavernous internal carotid artery, moved into the meningohypophyseal trunk and occluded it. Although the distal markers were positioned optimally, we did not expect the proximal marker to be in the position where it was located. Fortunately, cranial nerve dysfunctions and pituitary deficiency did not develop. It is important to prevent ischemic injury by occlusion of the perforators or branching vessels that can be caused by malpositioned stent markers. We consider where the proximal marker of the stent might be located after detachment.https://www.karger.com/Article/FullText/492110Meningohypophyseal trunkProximal markerSolitaireTM AB Neurovascular Remodeling Device
spellingShingle Won-Bae Seung
Herniated Proximal Marker of the Stent into the Meningohypophyseal Trunk after Stent-Assisted Coil Embolization for Intracranial Aneurysms
Case Reports in Neurology
Meningohypophyseal trunk
Proximal marker
SolitaireTM AB Neurovascular Remodeling Device
title Herniated Proximal Marker of the Stent into the Meningohypophyseal Trunk after Stent-Assisted Coil Embolization for Intracranial Aneurysms
title_full Herniated Proximal Marker of the Stent into the Meningohypophyseal Trunk after Stent-Assisted Coil Embolization for Intracranial Aneurysms
title_fullStr Herniated Proximal Marker of the Stent into the Meningohypophyseal Trunk after Stent-Assisted Coil Embolization for Intracranial Aneurysms
title_full_unstemmed Herniated Proximal Marker of the Stent into the Meningohypophyseal Trunk after Stent-Assisted Coil Embolization for Intracranial Aneurysms
title_short Herniated Proximal Marker of the Stent into the Meningohypophyseal Trunk after Stent-Assisted Coil Embolization for Intracranial Aneurysms
title_sort herniated proximal marker of the stent into the meningohypophyseal trunk after stent assisted coil embolization for intracranial aneurysms
topic Meningohypophyseal trunk
Proximal marker
SolitaireTM AB Neurovascular Remodeling Device
url https://www.karger.com/Article/FullText/492110
work_keys_str_mv AT wonbaeseung herniatedproximalmarkerofthestentintothemeningohypophysealtrunkafterstentassistedcoilembolizationforintracranialaneurysms