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Marker alignment for Guglielmi detachable coil embolization: practical considerations.

O-Ki Kwon¹, Moon Hee Han

¹Neurovascular Center, Inje University, Seoul Paik Hospital, Department of Radiology, Seoul National University College of Medicine, Korea.

AJNR. American Journal of Neuroradiology

|September 12, 2002

Summary

Proper Guglielmi detachable coil (GDC) placement depends on precise marker alignment. Factors like microcatheter type, shaping, and sterilization significantly influence coil detachment zone positioning during aneurysm embolization.

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Area of Science:

Neurosurgery
Interventional Radiology
Medical Device Engineering

Background:

Aneurysm embolization using Guglielmi detachable coils (GDCs) carries inherent risks.
Technical aspects before, during, and after the procedure require careful consideration.

Purpose of the Study:

To determine the position of the GDC detachment zone relative to the microcatheter tip.
To evaluate this positioning across various microcatheters and marker alignments.

Main Methods:

Tested six common microcatheter types (Excel-14, Excelsior, FasTracker-10, Prowler-10, Prowler-14, Rebar-14).
Compared catheter marker dimensions and distances from the tip.
Assessed coil maker alignment with catheter markers.
Modified microcatheter tips (shaping, steaming) and tested resterilized devices.

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Main Results:

Significant variation in catheter marker length and tip-to-marker distances observed among microcatheters.
GDC detachment zone positioned 1.0-1.5 mm beyond the catheter tip with proximal marker alignment.
Shaping, steaming, and resterilization affected GDC protrusion.
Microcatheters showed susceptibility to stretching during handling.

Conclusions:

Accurate marker alignment for GDC embolization is multifactorial.
Microcatheter type, steaming, shaping, sterilization, and handling all influence final coil positioning.