Case 1: 56-year-old female presented with ruptured tri-lobed 4x3 mm Anterior communicating artery aneurysm. Hunt and Hess (H&H) Grade 2. Modified Fisher scale (MFS) 4. Underwent primary coil embolization. Two 2mmx2cm Galaxy Orbit coils were deployed within aneurysm. During deployment of third coil the first two coils displaced out of the aneurysm migrating into left A2 segment. Stryker’s Trevo 3x20 mm stent retriever was used for retrieval of coils however they dislodged at the left internal carotid artery (ICA) terminus and migrated distally into the left middle cerebral artery (MCA) M2 superior division. Subsequently, Medtronic’s Solitaire stent retriever was successfully deployed retrieving the migrated coils with full recanalization.
Case 2: 64-year-old female presented with ruptured 3x5.3 mm right posterior communicating artery aneurysm. H&H 5 and MFS 4. Underwent primary coil embolization with placement of Galaxy Orbit 2.5mmx3.5cm coil. On follow up run, coil mass had migrated into the origin of right fetal Pcom. Migrated coil was successfully retrieved using Stryker’s stent retriever with complete recanalization.
Case 3: 65-year-old female with ruptured 8.5 x 6.8 mm right supraclinoid ICA aneurysm. H&H Grade 1. MFS 3. Underwent primary coil embolization with one Galaxy coil with plan for future flow diversion. Two weeks later, patient experienced acute neurological worsening with new left sided hemiparesis and right gaze deviation. Imaging revealed acute occlusion of right middle cerebral artery M1 segment occlusion with thrombosed migrated coil. Patient underwent retrieval of the coil and superimposed thrombus utilizing Stryker’s Trevo stent retriever with resultant full recanalization.