Late-occurring coil migration into the duodenum

Kuhara, Asako; Koganemaru, Masamichi; Ishikawa, Hiroto; Abe, Toshi

doi:10.1136/bcr-2012-007759

Cited by 8 publications

(9 citation statements)

References 2 publications

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“…4,5 The cause of the migration is often unknown, but previous papers have theorized that embolization of pseudoaneurysm or ulcers is susceptible to migration due to the proximity of the coil to the gastrointestinal lumen. 6,7 In our literature review, the presentation of coil migration ranged from 3 weeks to 5 years after embolization. 5,6 Multiple cases resulted in an operation, with 2 of the patients presenting with hypovolemic shock secondary to a gastrointestinal bleed.…”

Section: Discussionmentioning

confidence: 99%

“…Of the remaining cases, only 2 were treated with endoscopic removal, while all others were treated with expectant management. [6][7][8][9] Removal of embolization coils has a theoretical risk of causing intestinal perforation and continued gastrointestinal bleeding; however, the removal of coils is invasive and associated with inherent risks. Embolization coils are often placed in patient populations with complex anatomy and physiology.…”

Section: Discussionmentioning

confidence: 99%

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Endovascular Coil Migration Into the Intestinal Lumen: Two Cases of Successful Nonoperative Management

French

Hayes

2018

Vasc Endovascular Surg

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Endovascular embolization of visceral arteries is commonly performed as treatment for aneurysms, pseudoaneurysms, and emboloradiation of liver tumors; while considered relatively safe, it is not without complications. We are reporting 2 cases of coil migration into the gastrointestinal tract. Patients were successfully managed without endoscopic or surgical coil removal. Patients were followed after discharge and noted to have no further complications from their migrated coils. These cases highlight the success of expectant management for coil migration. We recommend against invasive intervention for coil removal as first-line treatment for endovascular coil migration into the intestinal tract. We urge providers to weigh the risks and benefits of coil removal, prior to invasive intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endovascular Coil Migration Into the Intestinal Lumen: Two Cases of Successful Nonoperative Management

French

Hayes

2018

Vasc Endovascular Surg

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“…Long-term follow-up with plain radiographs has been done to detect migration of coils in a few case reports [9]. Hot biopsy forceps was used to cut the wires and the migrated coils were successfully removed in one case report and another described using endoscopic scissors to cut the coils and extracting it in a piecemeal fashion with the help of raw-toothed forceps [8][9][10]. Bleeding is a major risk for the removal of migrated coils using the above procedures.…”

Section: Discussionmentioning

confidence: 99%

Rare Complication of Interventional Radiology-guided Arterial Embolization of the Gastroduodenal Artery in the Setting of Acute Gastrointestinal Bleed: Migrated Coils in the Duodenum

Kudaravalli

Saleem

Pendela

et al. 2020

Cureus

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A 91-year-old male presented to the emergency room with hemodynamically significant upper gastrointestinal bleeding. The patient underwent an esophagogastroduodenoscopy (EGD), which showed frank blood in the duodenum interfering with the visualization. Hence, the patient underwent urgent interventional radiology (IR)-guided arteriogram and embolization. An EGD done 48 hours later showed a giant, non-bleeding, cratered duodenal ulcer with a visible vessel and vascular coils partially protruding into the duodenal bulb lumen. The patient had no evidence of bleeding post embolization. The patient presented three months later with abdominal pain. Computed tomography (CT) abdomen showed multiple liver abscesses. IRguided drainage of abscesses was performed, and the culture grew Streptococcus intermedius. Magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and barium enema were unremarkable. The patient was treated with a prolonged course of intravenous (IV) antibiotics and recovered without any further issues. IR guided arterial embolization can be lifesaving in cases where GI bleeding cannot be controlled endoscopically, however, it can lead to serious complications, including endovascular coil migration into the gastrointestinal (GI) lumen causing infection and rebleeding. Endovascular coil migration can occur immediately or several years later, which can result in fatal bleeding and infection. The best approach to prevent and manage migrated endovascular coils in the GI lumen remains unclear.

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Section: Discussionmentioning

confidence: 99%

“…For example, several authors have described cases of coil migration from the GDA to the duodenum after arterial embolization for bleeding ulcers or iatrogenic trauma to the GDA after a surgical resection of bile duct carcinoma [6] , [7] , [8] , [9] . In the former case, the patient presented with recurrent gastrointestinal bleeding related to coil migration to the base of the ulcer [7] , whereas the patient in the latter case remained asymptomatic [8] . GDA coil migration into the stomach has also been reported, including migration into the gastric antrum following a prophylactic embolization of the GDA before transarterial chemoembolization [10] , as well as into the gastric pylorus in a patient with a history of chronic pancreatitis [5] .…”

Section: Discussionmentioning

confidence: 99%

Biliary obstruction necessitating choledochojejunostomy as a complication of endovascular coil erosion

Zuberi

Dinglasan

2018

Radiology Case Reports

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We report the case of a 55-year-old patient presenting with biliary obstruction caused by coil migration from a recently performed embolization of a post-traumatic gastroduodenal artery pseudoaneurysm. Based on imaging findings, biliary drain placement was initially performed and the subsequent endoscopy demonstrated coil erosion into the common bile duct and duodenum, resulting in choledochoduodenal fistula. Choledochojejunostomy was thereafter performed to bypass the area of injury.

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Late-occurring coil migration into the duodenum

Cited by 8 publications

References 2 publications

Endovascular Coil Migration Into the Intestinal Lumen: Two Cases of Successful Nonoperative Management

Endovascular Coil Migration Into the Intestinal Lumen: Two Cases of Successful Nonoperative Management

Rare Complication of Interventional Radiology-guided Arterial Embolization of the Gastroduodenal Artery in the Setting of Acute Gastrointestinal Bleed: Migrated Coils in the Duodenum

Biliary obstruction necessitating choledochojejunostomy as a complication of endovascular coil erosion

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