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CardioVascular and Interventional Radiology

, Volume 39, Issue 12, pp 1797–1800 | Cite as

Transvenous Salvage of Migrated Large Volume Detachable Coil

  • Uei PuaEmail author
  • Lawrence Han Hwee Quek
  • Glenn Wei Leong Tan
Letter to the Editor
  • 247 Downloads

To the Editor,

Recently, large volume detachable coils such as Ruby coils (Penumbra, Alameda, California) have become available for use in peripheral intervention and presents as an alternative to conventional embolization techniques. We describe a case of coil migration during embolization of an aneurysmatic renal arterio-venous malformation (AVM) and describe our salvage technique.

A 60-year-old woman was presented with right flank pain for 5–7 months duration, and a 33 × 32 × 29 mm hypervascular lesion was found in the right renal hilum on CT (Fig.  1). Time-resolved MR angiography showed the lesion to be the aneurysm sac related to a renal AVM (Movie 1), and she was referred for embolization.

Keywords

Renal Vein Onyx Main Renal Artery Liquid Embolic Agent Visceral Aneurysm 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest pertaining to the contents of this manuscript.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study formal consent is not required.

Supplementary material

MOVIE 1: Time resolved contrast enhanced MR angiography showed the lesion to be a saccular aneurysm with arterial supply and early venous drainage (note the early enhancement of the right renal vein), consistent with an arterio-venous malformation. (AVI 520 kb)

MOVIE 2: Right renal angiography showing prompt opacification of the aneurysm sac with early venous drainage, consistent with an arterio-venous malformation. (AVI 196 kb)

MOVIE 3: Captured coil being pushed into the center core of the coil complex. (AVI 2561 kb)

MOVIE 4: Captured coil being pushed and repositioned around the periphery of the coil complex and successfully released. (AVI 2717 kb)

MOVIE 5: Completion renal arteriography. (AVI 311 kb)

MOVIE 6: Follow-up angiography at 6 months. (AVI 300 kb)

References

  1. 1.
    Buck DB, Curran T, McCallum JC, Darling J, Mamtani R, van Herwaarden JA, et al. Management and outcomes of isolated renal artery aneurysms in the endovascular era. J Vasc Surg. 2016;63(1):77–81.CrossRefPubMedGoogle Scholar
  2. 2.
    Yasumoto T, Osuga K, Yamamoto H, Ono Y, Masada M, Mikami K, et al. Long-term outcomes of coil packing for visceral aneurysms: correlation between packing density and incidence of coil compaction or recanalization. J Vasc Interv Radiol. 2013;24(12):1798–807.CrossRefPubMedGoogle Scholar
  3. 3.
    Teigen C, Moyle H, Patel RS, Fischman AM, Kim E, Baxter B, Quarfordt S, Heck D, Klucznik R, et al. Experience using the penumbra ruby coil in the peripheral vasculature: ace multicenter study preliminary results. J Vasc Interv Radiol. 2015;26(1):s148.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2016

Authors and Affiliations

  • Uei Pua
    • 1
    • 2
    Email author
  • Lawrence Han Hwee Quek
    • 1
    • 3
  • Glenn Wei Leong Tan
    • 4
  1. 1.Department of Diagnostic RadiologyTan Tock Seng HospitalSingaporeSingapore
  2. 2.Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  3. 3.Lee Kong Chian School of MedicineNanyang Technological UniversitySingaporeSingapore
  4. 4.Department of General SurgeryTan Tock Seng HospitalSingaporeSingapore

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