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AJNR - American Journal of Neuroradiology

Published ahead of print on August 21, 2008
doi: 10.3174/ajnr.A1268

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Stent Management of Coil Herniation in Embolization of Internal Carotid Aneurysms

C.-B. Luo^a, F.-C. Chang^a, M.M.-H. Teng^a, W.-Y. Guo^a and C.-Y. Chang^a

^a From the Department of Radiology, Taipei Veterans General Hospital and National Yang Ming University School of Medicine, Taipei, Taiwan, Republic of China

View larger version (80K): [in this window] [in a new window]   Fig 1. Images of a 62-year-old woman who presented with subarachnoid hemorrhage. A, Right carotid angiogram shows a right ICA paraophthalmic narrow-neck aneurysm (arrow). B, Coil herniation into the ICA is found at the end of the embolization because of instability of the detached coil (arrow). C, A self-expandable stent was deployed into the ICA to push the herniated coil into the aneurysm sac and fix it to the vascular wall (arrowhead). D, Postembolization angiogram reveals subtotal occlusion of the aneurysm sac with patency of the ICA lumen. Note a supporting guidewire in the ICA and MCA.

View larger version (90K): [in this window] [in a new window]   Fig 2. Images of a 63-year-old woman who had ptosis after balloon embolization of a traumatic carotid cavernous fistula. A, A left carotid angiogram reveals a wide-neck aneurysm at the stenotic cavernous portion of the ICA. B, Excessive embolization with coil herniation into the ICA leading to compromise of the ICA lumen and flow is found. C–E, A balloon-mounted stent (black and white arrows) is deployed into the ICA to reconstruct the lumen and blood flow of the ICA.