Basilar Artery Bifurcation Aneurysm: Small Wide-Necked Incidental Basilar Artery Bifurcation Aneurysm, Treated with Staged pCONUS1 HPC Implantation and Coil Occlusion; Protrusion of a Coil Loop into the Basilar Artery Bifurcation, Which Prompted the Removal of That Coil Using an Alligator Device

  • Alexander SirakovEmail author
  • Muhamad Elhalal
  • Klaus Terstegge
  • Erich Donauer
  • Hans Henkes
Living reference work entry


A 64-year-old man underwent an MRI/MRA examination as a diagnostic work-up for an epileptic seizure. A small, saccular, wide-necked aneurysm of the basilar artery bifurcation was diagnosed and endovascular treatment thus offered. A pCONUS1 HPC was successfully implanted into the aneurysm and the distal basilar artery. Coil occlusion was scheduled for 7 weeks later. While inserting the coils, a loop from an already detached 3D coil migrated from the aneurysmal dome into the shaft of the pCONUS1 HPC, protruding into the basilar artery bifurcation. This herniating coil loop was considered a potential source of emboli. It was therefore removed with an Alligator Retrieval Device. The coil occlusion of the aneurysm was completed as intended. The endovascular removal of dislodged coils is the main topic of this chapter.


Basilar artery bifurcation pCONUS1 HPC Misplaced coils Alligator retrieval device Foreign body removal 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Alexander Sirakov
    • 1
    Email author
  • Muhamad Elhalal
    • 2
  • Klaus Terstegge
    • 2
  • Erich Donauer
    • 3
  • Hans Henkes
    • 1
  1. 1.Neuroradiologische KlinikKlinikum StuttgartStuttgartGermany
  2. 2.Klinik für Radiologie und NeuroradiologieMediClin Krankenhaus Plau am SeePlau am SeeGermany
  3. 3.Klinik für Neurochirurgie und StereotaxieMediClin Krankenhaus Plau am SeePlau am SeeGermany

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