ArticleJournal of neurosurgery. Case lessons2026
Delayed coil migration after endovascular treatment of a ruptured intracranial aneurysm managed by open microsurgical surgery: illustrative case.
Article in Journal of neurosurgery. Case lessons, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEndovascular coil embolization is widely used for the treatment of ruptured intracranial aneurysms because of its minimally invasive nature and rapid effectiveness. However, coil migration is a rare but potentially severe complication that may lead to parent artery occlusion, thromboembolism, or cerebral infarction, requiring prompt management. OBSERVATIONS: A 65-year-old woman presented with subarachnoid hemorrhage caused by a ruptured intracranial aneurysm. She underwent emergency endovascular coil embolization. Postprocedural CT angiography revealed migration of the coil into the parent artery, posing a high risk of vascular compromise. Emergency open microsurgical intervention was performed. The migrated coil was carefully retrieved through arteriotomy, and the aneurysm neck was successfully clipped. Postoperative angiography demonstrated preserved cerebral blood flow and complete aneurysm occlusion. The patient recovered with neurological deficits and was discharged in stable condition. LESSONS: Open microsurgical coil retrieval combined with aneurysm clipping can be an effective treatment option in selected cases of coil migration, particularly when endovascular retrieval is not feasible or carries significant risk. Early recognition of this complication and timely multidisciplinary decision-making are essential to prevent ischemic injury and achieve acceptable outcomes. https://thejns.org/doi/10.3171/CASE26239.
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