Microguidewire-Assisted Repositioning of a Protruding Coil After Aneurysm Embolization

Abstract Coil protrusion is a rare but potentially serious complication of intracranial aneurysm embolization. Although several solutions exist, many raise procedural costs or require dual antiplatelet therapy. This case highlights a safe, cost-effective method for repositioning a protruding coil using only a microcatheter and microguidewire. An elderly patient with a left MCA bifurcation aneurysm experienced coil protrusion during embolization. A microguidewire, shaped and advanced via the inferior MCA trunk as a fulcrum, successfully repositioned the coil without extra devices or antiplatelet therapy. Post-procedure imaging confirmed stable repositioning without ischemic or hemorrhagic events. The patient developed moderate vasospasm, treated medically, and showed significant functional recovery after three months. This specific technique provides a simple, effective, and economical alternative for managing coil protrusion, minimizing risks and costs while potentially improving outcomes in both standard and complex aneurysm cases.