EJVES vascular forum · 2025
Coil Migration: From Ruptured Aortic Pseudoaneurysm to Bronchus.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Liu Hao, Dong Zhihui, Fu Weiguo
Аннотация
INTRODUCTION: Coil migration is an extremely infrequent finding after aneurysm coil embolisation. This case report presents a rare complication of a ruptured tuberculous aortic pseudoaneurysm that was managed by an endoscopic technique.
REPORT: A patient presented with a ruptured tuberculous aortic arch pseudoaneurysm after receiving an emergency endovascular repair and aneurysm embolisation. After eight months, the patient returned with the sensation of a foreign body in the larynx. Computed tomography angiography (CTA) showed coil migration from the aneurysmal sac to the bronchus, trachea, and larynx, with bronchoscopy confirming the finding. Most coils within the respiratory system were disintegrated by Q switched neodymium-yttrium aluminium garnet laser and hook scissors and then removed. The patient's symptoms were relieved and follow up CTA showed no more migrated coils.
DISCUSSION: This case highlights that coil embolisation should be employed with extreme caution, or even avoided in mycotic aortic aneurysms, particularly when ruptured, given the potential consequences. A rigorous and consistent follow up protocol is essential to monitor the aneurysm for changes and to detect any complications related to the coils, particularly in the presence of a pre-existing "channel". Endoscopic techniques could be used as treatment methods for coil migration.
REPORT: A patient presented with a ruptured tuberculous aortic arch pseudoaneurysm after receiving an emergency endovascular repair and aneurysm embolisation. After eight months, the patient returned with the sensation of a foreign body in the larynx. Computed tomography angiography (CTA) showed coil migration from the aneurysmal sac to the bronchus, trachea, and larynx, with bronchoscopy confirming the finding. Most coils within the respiratory system were disintegrated by Q switched neodymium-yttrium aluminium garnet laser and hook scissors and then removed. The patient's symptoms were relieved and follow up CTA showed no more migrated coils.
DISCUSSION: This case highlights that coil embolisation should be employed with extreme caution, or even avoided in mycotic aortic aneurysms, particularly when ruptured, given the potential consequences. A rigorous and consistent follow up protocol is essential to monitor the aneurysm for changes and to detect any complications related to the coils, particularly in the presence of a pre-existing "channel". Endoscopic techniques could be used as treatment methods for coil migration.