Successful Retrieval of Migrated Coil Tangle in Femoral Artery Following Aneurysm Embolization: A Case Report.

BACKGROUND Stretching of embolization coils is a known complication of embolization procedures with potential outcomes including thrombosis, embolism, or vascular occlusion. This unpredictable event occurs in 0.5% to 6% of cases and can be asymptomatic or clinically significant, especially if associated with thrombosis. CASE REPORT We describe a case involving a stretched and unraveled embolization coil that migrated from its original placement site in the middle right cerebral artery to the common femoral artery. The coil formed a tangle and became symptomatic following cerebral artery aneurysm repair. The migrated coil was identified using ultrasound and confirmed with unenhanced computed tomography. Various techniques are available to manage stretched coils, depending on the location of dislocation and the associated risks of thrombosis or bleeding. To prevent femoral axis thrombosis in this case, we opted to retrieve the migrated coil and secure it outside the vessel lumen. The procedure involved accessing the superficial femoral artery, advancing a vascular introducer sheath to the coil tangle, and using a snare-type retrieval system to capture the coil within the introducer. The coil was then cut and implanted into the subcutaneous fat outside the artery. The procedure was successfully completed without complications. CONCLUSIONS This case highlights the importance of prompt detection and management of embolization coil complications to prevent serious consequences such as thrombosis or vascular occlusion. Advanced imaging techniques, coupled with endovascular retrieval strategies, can ensure successful outcomes with minimal risks for the patient. The approach described here demonstrates an effective and safe solution for managing migrated and stretched embolization coils.