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Published in: Acta Neurochirurgica 11/2018

01-11-2018 | Technical Note - Vascular Neurosurgery - Other

Snare technique for endovascular retrieval of coil extending to the atrium after embolization of a dural arteriovenous fistula

Authors: Xianzeng Tong, Kunyang Bao, Peng Hu, Tao Hong, Meng Li, Peng Zhang, Hongqi Zhang

Published in: Acta Neurochirurgica | Issue 11/2018

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Abstract

Background

No data exist regarding retrieval of displaced or stretched coil extending to the right atrium after endovascular embolization of cerebrovascular diseases. We describe a snare technique for retrieval of a displaced coil extending to the right atrium after embolization of dural arteriovenous fistula (DAVF).

Methods

A 35-year-old female with a DAVF underwent transjugular coil embolization that failed with displaced coil extending to the right atrium at an outside hospital. After admission to our hospital, Onyx embolization of the DAVF was performed through left facial vein–inner canthus vein–superior ophthalmic vein to the cavernous sinus. Post-embolization angiography showed complete occlusion of the DAVF. Then we attempted to snare the tip of the displaced coil that extended to the right atrium through femoral vein–inferior vena cava approach. However, current snare techniques failed to retrieve the extended coil after several attempts. Then one week later, we used a modified dual microcatheter and microwire technique to retrieve the displaced coil. One suite of microcatheter and microwire was used to produce a handmade snare device (HMD). The other suite of microcatheter and microwire was used to assist the HMD to snare the displaced coil.

Results

Through transjugular vein approach, we used our modified dual microcatheter and microwire snare technique (handmade snare device system) to retrieve the extended coil. After several attempts, the extended coil in the atrium was successfully retrieved. Post-procedure angiography and cardiac examinations did not show any signs of abnormality.

Conclusions

For displaced coil extending to the right atrium after transvenous embolization, our method of modified dual microcatheter technique with HMD snare device system is an effective method to retrieve the extending coil.
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Metadata
Title
Snare technique for endovascular retrieval of coil extending to the atrium after embolization of a dural arteriovenous fistula
Authors
Xianzeng Tong
Kunyang Bao
Peng Hu
Tao Hong
Meng Li
Peng Zhang
Hongqi Zhang
Publication date
01-11-2018
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 11/2018
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-018-3667-9

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