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Research ArticleInterventional

Retrieval of Migrated Coils with Stent Retrievers: An Animal Study

O. Nikoubashman, R. Pjontek, M.-A. Brockmann, R. Tolba and M. Wiesmann
American Journal of Neuroradiology June 2015, 36 (6) 1162-1166; DOI: https://doi.org/10.3174/ajnr.A4240
O. Nikoubashman
aFrom the Department of Neuroradiology (O.N., R.P., M.-A.B., M.W.)
cMedical Imaging Physics (O.N.), Institute of Neuroscience and Medicine 4, Forschungszentrum Jülich, Jülich, Germany.
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R. Pjontek
aFrom the Department of Neuroradiology (O.N., R.P., M.-A.B., M.W.)
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M.-A. Brockmann
aFrom the Department of Neuroradiology (O.N., R.P., M.-A.B., M.W.)
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R. Tolba
bInstitute for Laboratory Animal Science and Experimental Surgery (R.T.), University Hospital Aachen, Aachen, Germany
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M. Wiesmann
aFrom the Department of Neuroradiology (O.N., R.P., M.-A.B., M.W.)
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    Fig 1.

    Illustration of the advanced retrieval technique with intentional trapping of the coil: The coil is passed with the microwire (A) followed by the microcatheter (B). Note that displacement of the coil might be encountered. The stent retriever should cover the coil with its distal two-thirds (C). The microcatheter is pushed forward while gently pulling back the stent retriever at the same time (D) to trap the coil. A resistance signals that the coil has been locked within the stent. At this point, both the microcatheter and the stent retriever are carefully withdrawn under fluoroscopic control.

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    Fig 2.

    Illustration of the retrieval technique applied if passage of the coil with the microcatheter is not possible. In this case, the microcatheter should be positioned directly proximal to the coil (A). The stent retriever is carefully pushed into the coil (B) and the microcatheter is pushed forward while gently pulling back the stent retriever at the same time (C) to trap the coil. A resistance signals that the coil has been locked within the stent. The microcatheter and the stent retriever are then withdrawn as described in Fig 1. Note that this technique is likely to be associated with an increased risk of vessel perforation and thus should only be performed after careful risk-benefit analysis.

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    Fig 3.

    A GDC-10 Soft SR coil (3 mm × 6 cm) migrated into a musculoskeletal branch of the axillary artery (A, arrow). The stent retriever is unsheathed with the distal two-thirds of the stent retriever covering the coil (B). The distal tip of the stent retriever is marked with a black arrow (B and C). The microcatheter is being pushed (B and C, white arrowhead) while slightly pulling the stent retriever backward until a resistance is felt to trap the coil. Once the coil is locked, both the microcatheter and the stent retriever are carefully withdrawn into the guiding catheter (D, arrow).

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American Journal of Neuroradiology: 36 (6)
American Journal of Neuroradiology
Vol. 36, Issue 6
1 Jun 2015
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Retrieval of Migrated Coils with Stent Retrievers: An Animal Study
O. Nikoubashman, R. Pjontek, M.-A. Brockmann, R. Tolba, M. Wiesmann
American Journal of Neuroradiology Jun 2015, 36 (6) 1162-1166; DOI: 10.3174/ajnr.A4240

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Retrieval of Migrated Coils with Stent Retrievers: An Animal Study
O. Nikoubashman, R. Pjontek, M.-A. Brockmann, R. Tolba, M. Wiesmann
American Journal of Neuroradiology Jun 2015, 36 (6) 1162-1166; DOI: 10.3174/ajnr.A4240
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