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Case report
Republished: A direct aspiration first pass technique for retrieval of a detached coil
  1. Noritaka Masahira1,
  2. Tsuyoshi Ohta1,
  3. Naoki Fukui2,
  4. Toshio Yanagawa2,
  5. Yuichirou Kondou2,
  6. Masanori Morimoto1,
  7. Tetsuya Ueba2
  1. 1Department of Neurosurgery, Kochi Health Sciences Center, Kochi City, Kochi Prefecture, Japan
  2. 2Department of Neurosurgery, Kochi Medical School, Nankoku City, Kochi Prefecture, Japan
  1. Correspondence to Dr T Ohta, Department of Neurosurgery, Kochi Health Sciences Center, Kochi City, Kochi Prefecture, 781-8555, Japan; tsuyoshi{at}


A 64-year-old man was referred to our hospital for treatment of a cerebral aneurysm that was incidentally found. The aneurysm was 7 mm in size and located on the left anterior communicating artery. Using a balloon assisted technique, we performed coil embolization. During the second coil insertion, the first coil was dislodged into the anterior communicating artery. We attempted coil retrieval using a snare, which was unsuccessful. We applied a direct aspiration first pass technique (ADAPT) and advanced a Penumbra 4MAX immediately proximal to the dislodged coil; the dislodged coil was then successfully retrieved. ADAPT is a simple procedure for retrieval of a detached coil, and it can be used as an alternative to the snare technique.

  • Aneurysm
  • Angiography
  • Intervention
  • Coil
  • Complication

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  • Republished with permission from BMJ Case Reports Published 6 November 2015; doi:10.1136/bcr-2015-012039

  • Contributors NM was an attending physician of the patient described in this case report and wrote the draft of the manuscript. TO conducted, corrected, and finalized the manuscript. NF, TY, and YK participated in the treatment and operation of the case. MM and TU were supervisors and provided important suggestions. All authors read and approved the final manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.