Delayed coil migration following endovascular coiling of intracranial aneurysms: a systematic review and institutional case series.

Authors

Danial Aminaei, Annika Mascarenhas, Victor Yang, Manas Sharma

Published in

Journal of neurointerventional surgery. Sep 07, 2026. Epub Sep 07, 2026.

Abstract

To systematically investigate delayed coil migration following endovascular coiling of intracranial aneurysms, augmented by two institutional cases.
A systematic review was conducted using MEDLINE, Embase, and Scopus from inception to June 27, 2025. Eligible cases involved coil migration after the index procedure; two institutional cases were added. Data were extracted using a standardized form and were analyzed descriptively.
Thirty-two cases were identified: 30 from 17 prior studies and two institutional. Mean patient age was 54.9 years and 59.4% of aneurysms were ruptured. Mean aneurysm diameter was 5.2 mm and mean aspect ratio was 1.87, with half of those with a calculable aspect ratio below the 1.6 high-risk threshold. The anterior communicating artery was the most frequently affected location (28.1%). Detection ranged from less than 24 hours to more than 6 months post-procedure. Migrated coils most often lodged in the middle and anterior cerebral artery territories, and vessel occlusion occurred in 28.1%. Medical management of the migrated coil was the primary treatment (56.0%), and 11 of 14 medically managed patients (78.6%) were asymptomatic or had good recovery. Re-treatment was reported in 37.5% of cases, all with favorable outcomes at follow-up.
Delayed coil migration predominantly affects small, broad-necked aneurysms in the anterior circulation. Medical management of the migrated coil yielded favorable outcomes in asymptomatic patients without vessel occlusion. Re-treatment in over one-third of cases had excellent outcomes. Early post-procedural imaging is recommended, and given the recanalization risk, long-term surveillance beyond standard post-coiling protocols may also be warranted.

PMID:
42705911
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.

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