Delayed coil migration from an anterior communicating aneurysm: a rare complication

Coil migration is an infrequent but potentially serious complication after cerebral aneurysm embolization and may occur either early or late in the postoperative period.This report describes a rare case of delayed coil migration from an anterior communicating artery aneurysm and reviews potential contributing factors.We report the case of a 51-year-old man with a ruptured anterior communicating artery aneurysm who underwent coil embolization using the double-microcatheter technique without stent insertion.Twelve days after the procedure, the patient presented with left leg weakness and gait disturbance, and brain magnetic resonance angiography demonstrated coil migration to the right A2 segment.This case highlights the rarity of delayed coil migration, emphasizes the need to consider this complication, and discusses possible contributing factors, including aneurysm shape and location, a broad neck, a low dome-to-neck ratio, coil size and design, use of soft coils, microcatheter kickback, and cerebral vasospasm.Although delayed coil migration after endovascular treatment of an aneurysm is exceedingly rare, it may lead to severe ischemic complications.Therefore, awareness of this uncommon complication and implementation of strategies to minimize its occurrence are essential.