Purpose: The migration of endovascular coils is a relatively rare complication, with few cases reported in patients with pelvic congestion syndrome. Additionally, the coil retrieval process has not been well described. Case report: A 39-year-old female with recent coil embolization of her left internal iliac and ovarian veins for pelvic congestion syndrome presented with one month of rightsided chest pain and dyspnea. Chest radiograph and computed tomography (CT) imaging revealed a migrated pelvic coil in the patient’s right main pulmonary artery with associated pulmonary infarcts and a small right pleural effusion. Interventional radiology successfully removed the coil piecemeal via a bilateral femoral access approach, resulting in significant symptom improvement and only a small piece of coil left in situ. Conclusions: Careful history should be obtained in patients presenting with chest pain or dyspnea, including recent procedures. Endovascular retrieval of the migrated coil was a successful and safe intervention in this patient, resulting in symptom resolution without the requirement of long-term anticoagulation or monitoring. The patient was also spared a more invasive open surgical procedure, which could lead to prolonged recovery times and increased complication risk.
Angel Guerrero and Rebecca G Theophanous