Coil from leg veins takes a "tour" of heart, An extremely rare case of coil migration

Percutaneous embolization of the testicular vein with coils is a commonly performed treatment of varicocele. Reports of intravascular migration of embolization coils are rare. A case report published recently in JACC discusses multimodality-imaging based diagnosis and management of such a coil migration to the right ventricle (RV). This is the first-ever case of varicose-vein coil translocation to the heart.

A 29-year-old male patient presented with atypical left-sided chest pain and cold fingers and hands. He had a history of smoking. His physical examination was unremarkable. At age of 15 years, he had a varicocele operation when approximately 14 microcoils were inserted (measuring 7 x 70 mm).

He was referred to the rheumatology team in 2015 to investigate the cause of his peripheral vasospastic symptoms and exclude a connective tissue disorder, vasculitis, or primary Raynaud phenomenon. He had a chest radiograph that revealed a foreign structure (Figure). Further cardiac investigations including cardiac magnetic resonance imaging, a 3-dimensional transthoracic echocardiogram, and a computed tomogram were performed. The computed tomography confirmed a foreign body in the heart; however, mass could not be localized because of artefact from the foreign body (Figure). It was also difficult to assess the exact location on cardiac magnetic resonance imaging. A 2-dimensional and 3-dimensional transthoracic echocardiogram (Figure) identified a well-defined 3.3-cm foreign object in the basal right ventricle attached to the posterior annulus of the tricuspid valve measuring. There was mild tricuspid insufficiency. The biventricular size and function were normal.