Successful Cutting and Retrieval of an Unraveled Embolization Coil With Rotational Atherectomy: A Case Report

Coil unraveling is a rare but potentially serious complication during transcatheter coil embolization. Once the braided coil has unraveled and loosened into wire filaments, percutaneous retrieval becomes extremely challenging. Although various percutaneous techniques have been described for retrieving migrated or unraveled coils, surgical removal or leaving the coil in situ may ultimately be required. We describe the first case of successful cutting and retrieval of an unraveled coil during coil embolization for a coronary pulmonary artery fistula (CPAF) using rotational atherectomy (RA). This novel troubleshooting technique may represent a valuable last-resort option in situations where conventional retrieval attempts are unsuccessful.