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Arterial Occlusion With Coils

Donald L. Miller, MD
Arch Intern Med. 1985;145(9):1737. doi:10.1001/archinte.1985.00360090213039.
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To the Editor.  —The case report by Nakamura and co-workers1 in the January 1985 Archives may be misleading.First, partial proximal projection of a Gianturco-Wallace occlusion coil has been previously reported by Weber2 and by Chuang and associates3; it is not a new finding. It may occur due to catheter recoil as the coil is being placed,3 placement of too many coils in the vessel to be occluded, improper selection of coil size, or incomplete initial expulsion of the coil.4Second, incorrect coil placement is usually not innocuous. Incorrectly placed coils may migrate back out of the target vessel and embolize downstream in the parent vessel,4 cause localized stenosis of the parent vessel,3 or perforate the vessel wall.4 The authors' Fig 2 appears to demonstrate thrombus around a portion of the coil in the right subclavian artery, with associated localized arterial stenosis. This finding suggests that their patient


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