Background and importance When attempting through the stent technique in the stent assisted coiling, there is as risk of the distal stent migration due to the microwire or microcathter. However, we had never seen a case in which a stent slipped downward in the literature review. We report a case of proximal stent migration.

Clinical presentation A 79 - year - old female patient was admitted with a wide neck aneurysm of the middle cerebral artery. The stent-assisted coil was designed to be saving the incorporated branch. With jailing technique, one microcathter was placed in the sac, then the Neuroform Atlas stent was deployed, and another microcatheter was delivered with the through the stent technique for double microcatheter technique. During the re-cross the stent the distal migration was observed. We try removal of the microwire and microcatheter. At the moment of puling the microcatheter and microwire to remove, the existing stent was pulled downward. The patient had a cerebral infarction result in left side motor weakness, can walking with cane.

Discussion The patient was neurologically compromised by unexpected proximal stent migration. Distal stent migration may occur occasionally, but proximal migration is the first experience reported.

Conclusion Physician may remember that unexpected events may occur, and we think that more attention well be needed when doing something. Other reader may wish to remember that this can happen.

Disclosures Y. Jung: None. H. Lee: None. J. Kim: None. C. Chang: None.