Early Migration of a Self Expanding Intracranial Stent

OBJECTIVE With the development of support devices such as stents, an increasing number of aneurysms are meeting the criteria for endovascular treatment. A range of intracranial stents currently are available with an array of characteristics. It is essential to understand the properties of these stents to determine their role and implications in endovascular treatment of cerebral aneurysms. CLINICAL PRESENTATION A 45-year-old man presented to our institution with subarachnoid hemorrhage secondary to a small distal basilar trunk aneurysm. INTERVENTION An Enterprise stent (4.5 × 14 mm) was deployed in the parent vessel across the neck of the aneurysm. Repeat angiography 2 days later demonstrated significant proximal stent migration. A second, longer overlapping Enterprise stent (4.5 × 22 mm) was deployed from the left P1 segment into the basilar artery. Complete occlusion of the basilar trunk aneurysm was noted on subsequent angiography. CONCLUSION This is an unequivocal case of early spontaneous migration of a self-expanding intracranial stent. We suggest caution when there is significant discrepancy in luminal diameter and suboptimal wall apposition. Early imaging following stent deployment may be indicated in these cases.