Arterial Occlusion With Coils

To the Editor.  —The case report by Nakamura and co-workers¹ in the January 1985 Archives may be misleading.First, partial proximal projection of a Gianturco-Wallace occlusion coil has been previously reported by Weber² and by Chuang and associates³; it is not a new finding. It may occur due to catheter recoil as the coil is being placed,³ placement of too many coils in the vessel to be occluded, improper selection of coil size, or incomplete initial expulsion of the coil.⁴Second, incorrect coil placement is usually not innocuous. Incorrectly placed coils may migrate back out of the target vessel and embolize downstream in the parent vessel,⁴ cause localized stenosis of the parent vessel,³ or perforate the vessel wall.⁴ The authors' Fig 2 appears to demonstrate thrombus around a portion of the coil in the right subclavian artery, with associated localized arterial stenosis. This finding suggests that their patient