Parent vessel Guglielmi detachable coil herniation during wide-necked aneurysm embolization: Treatment with intracranial stent placement: Two technical case reports

OBJECTIVE AND IMPORTANCE: Despite recent advances in technology, parent ves sel coil herniation occasionally complicates successful Guglielmi detachabl e coil embolization, particularly in wide-necked aneurysms. We report endov ascular stent deployment performed in two patients specifically to treat th is complication. CLINICAL PRESENTATION: Two patients underwent Guglielmi detachable coil emb olization of cavernous segment aneurysms. Both developed coil herniation in to the internal carotid artery. In one patient, the herniation occurred dur ing the initial procedure; in the other, it was discovered in a delayed fas hion during a follow-up examination for ocular symptoms. INTERVENTION: In both patients, endovascular stent deployment was performed to isolate the herniated portion of the coil from the internal carotid lum en. Follow-up angiography at 6 months demonstrated no aneurysm recanalizati on and no stenosis of the parent internal carotid artery in the stented reg ion in either patient. CONCLUSION: The use of intraluminal stents has been reported to be a helpfu l technical adjunct to the conventional endovascular treatment of aneurysms and balloon angioplasty. One additional indication for the use of this tec hnology is sequestering herniated coils from the lumen of the parent artery to reduce potential embolic or occlusive sequelae.