Five patients were found to have spontaneous delayed migration/shortening of their Pipeline Embolization Devices on follow-up angiography . The device migrated proximally in 4 patients and distally in 1 patient . One patient had a subarachnoid hemorrhage and died as a result of migration of the Pipeline Embolization Device, and another patient presented with complete MCA occlusion and was left severely disabled . Mismatch in arterial diameter between inflow and outflow vessels was a constant finding . Migration of the Pipeline Embolization Device was managed conservatively, with additional placement of the device, or with parent vessel occlusion . Obtaining complete expansion of the embolization device by using a longer device, increasing vessel coverage, using adjunctive aneurysm coiling, and avoiding dragging and stretching of the device are important preventive measures . Neurointerventionalists should be aware of this potentially fatal complication and take all necessary preventive measures.
MeSH: Adult, Aged, Embolization, Therapeutic, adverse effects, instrumentation, Equipment Design, Equipment Failure, Fatal Outcome, Female, Foreign-Body Migration, diagnostic imaging, etiology, Humans, Intracranial Aneurysm, complications, diagnostic imaging, therapy, Male, Middle Aged, Radiography, Stents, adverse effects, Subarachnoid Hemorrhage, etiology, prevention & control, Treatment Failure