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Complex coil assisted single coil embolization for small intracranial aneurysm.

Ming-Shiang Yang¹, Tzu-Hsien Yang, Chang-Hsien Ou

¹Department of Radiology, Taitung Mackay Memorial Hospital, Taitung, Taiwan. ; Department of Radiology, China Medical University Hospital, Taichung, Taiwan.

Neurointervention

|September 12, 2013

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A new complex coil technique enhances safety for treating small intracranial aneurysms. This method uses a protective coil to stabilize embolization coils, preventing herniation and improving procedure safety.

Area of Science:

Interventional Neurology
Vascular Neurosurgery
Medical Devices

Background:

Treatment of intracranial aneurysms, particularly small ones, presents challenges in ensuring procedural safety and efficacy.
Traditional coil embolization can be complicated by coil migration or herniation into the parent artery.
Existing adjuncts like stents may carry risks of incomplete apposition or in-stent stenosis.

Purpose of the Study:

To introduce and describe a novel complex coil-assisted coil embolization technique for treating intracranial small aneurysms.
To enhance the safety and stability of coil embolization procedures for intracranial aneurysms.
To present a method that avoids leaving permanent devices in the parent artery.

Main Methods:

A dual microcatheter approach is employed.

Keywords:

Aneurysm, Ruptured/therapy Complex coil Embolization, Therapeutic/methods Intracranial aneurysm

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An ultrasoft coil is introduced into the aneurysm sac.

A second microcatheter delivers a complex protective coil into the parent artery adjacent to the aneurysm neck, creating a bridge to stabilize the embolization coil.

Dual-plane imaging is used for real-time monitoring of coil stability.

The protective coil is gently withdrawn after successful embolization.

Main Results:

The complex coil-assisted technique successfully stabilized the embolization coil within the aneurysm sac.
Coil herniation into the parent artery was prevented.
The protective coil did not impede parent artery flow.
Embolization coils were detached without evidence of motion or vibration, indicating stability.

Conclusions:

Complex coil-assisted coil embolization is a safe and effective technique for treating intracranial small aneurysms.
This method provides a physiological protective approach, enhancing embolization stability.
The technique avoids the need for permanent implantable devices in the parent artery, potentially reducing long-term complications.