Extensive stretching of intracranial aneurysm coil causing TIAs.

A 58-year-old man with a history of ruptured posterior cerebral artery aneurysm, repaired with coil embolization 5 years previously, presented with right hemi-numbness lasting 30 minutes. Cerebral MRI did not reveal acute stroke. CT angiogram showed a stretched wire complex extending through the posterior communicating artery, down the carotid artery, and into the most inferior visualized portion of descending aorta, terminating in a loosely coiled wire (figure, A and B). A transesophageal echocardiogram showed evidence of a possible thrombus on the coil in the aortic arch (figure, C and D; video on the Neurology® Web site at Neurology.org). Coil stretching and migration is a rare complication of endovascular coil repair and can predispose to embolic events.