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The patient was treated successfully with a flow diverter stent (FD) and coiling; however, a large aneurysm recurrence via a feeding posterior communicating artery (PCOM) was noted on the 1-year follow-up angiogram. During the retreatment, a second FD in the ICA resulted in insufficient aneurysm stasis. Therefore, the decision was made to coil sacrifice the PCOM via posterior circulation access. During the first coil deployment, the distal coil end migrated through the mesh of two overlapping FD into the middle cerebral artery. This complication was a previously unrecognised possibility given the composition of the FD. This case report aims to discuss this process as a potential complication during neurointerventional procedures using these devices.<\/jats:p>","DOI":"10.1136\/bcr-2023-256863","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T19:45:11Z","timestamp":1705607111000},"page":"e256863","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Coil migration through two flow-diverting stents"],"prefix":"10.1136","volume":"17","author":[{"given":"Patrick Scott","family":"Rogers","sequence":"first","affiliation":[{"name":"Diagnostic Imaging, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gwynedd","family":"Pickett","sequence":"additional","affiliation":[{"name":"Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Vandorpe","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Volders","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,18]]},"reference":[{"key":"2025082702090837000_17.1.e256863.1","first-page":"141","article-title":"An overview of intracranial aneurysms","volume":"9","author":"Keedy","year":"2006","journal-title":"MJM"},{"key":"2025082702090837000_17.1.e256863.2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.1.251"},{"key":"2025082702090837000_17.1.e256863.3","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1017\/S031716710003403X","article-title":"Causes of morbidity and mortality following intracranial aneurysm rupture","volume":"25","author":"Findlay","year":"1998","journal-title":"Can J Neurol Sci"},{"key":"2025082702090837000_17.1.e256863.4","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1002\/msj.20183","article-title":"Intracranial aneurysms: endovascular treatment","volume":"77","author":"Moyle","year":"2010","journal-title":"Mt Sinai J Med"},{"key":"2025082702090837000_17.1.e256863.5","doi-asserted-by":"publisher","DOI":"10.1177\/1971400915602803"},{"key":"2025082702090837000_17.1.e256863.6","doi-asserted-by":"crossref","first-page":"275","DOI":"10.7461\/jcen.2023.E2022.10.010","article-title":"Analysis of reported adverse events of pipeline stents for intracranial aneurysms using the FDA MAUDE database","volume":"25","author":"Porwal","year":"2023","journal-title":"J Cerebrovasc Endovasc Neurosurg"},{"key":"2025082702090837000_17.1.e256863.7","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4111"},{"key":"2025082702090837000_17.1.e256863.8","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.13120099"},{"key":"2025082702090837000_17.1.e256863.9","first-page":"A73","article-title":"E-064 institutional experience with Axium prime extra soft coil for treatment of intracranial aneurysms","volume":"9","author":"Delgado","year":"2017","journal-title":"J of Neurointerv Surg"},{"key":"2025082702090837000_17.1.e256863.10","doi-asserted-by":"publisher","DOI":"10.1177\/1591019918758493"},{"key":"2025082702090837000_17.1.e256863.11","doi-asserted-by":"publisher","DOI":"10.1177\/0003319717700503"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-256863","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:09:18Z","timestamp":1756285758000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-256863"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,18]]},"published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1136\/bcr-2023-256863"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-256863","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}