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Acta Neurochirurgica

, Volume 160, Issue 11, pp 2177–2186 | Cite as

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

  • Xianzeng Tong
  • Kunyang Bao
  • Peng Hu
  • Tao Hong
  • Meng Li
  • Peng ZhangEmail author
  • Hongqi Zhang
Technical Note - Vascular Neurosurgery - Other
  • 126 Downloads
Part of the following topical collections:
  1. Vascular Neurosurgery – Other

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.

Keywords

Dural arteriovenous fistula Endovascular embolization Coil displacement Coil retrieval technique 

Abbreviations

DAVF

Dural arteriovenous fistula

DSA

Digital subtraction angiography

HMD

Handmade snare device

MRI

Magnetic resonance imaging

Notes

Acknowledgements

Thanks to the dedicated work of the neurointerventional group of Xuanwu Hospital, Capital Medical University.

Compliance with ethical standards

This study was approved by the Institutional Review Board of Xuanwu Hospital, Capital Medical University.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study is a retrospective study. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from the patient and her relatives.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Xianzeng Tong
    • 1
  • Kunyang Bao
    • 2
  • Peng Hu
    • 1
  • Tao Hong
    • 1
  • Meng Li
    • 1
  • Peng Zhang
    • 1
    Email author
  • Hongqi Zhang
    • 1
  1. 1.Department of Neurosurgery, Xuanwu HospitalCapital Medical University, China International Neuroscience Institute (China-INI)BeijingChina
  2. 2.Department of NeurosurgeryThe Affiliated Hospital of Southwest Medical UniversityLuzhouChina

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