Versatile fill coils: initial experience as framing coils for oblong aneurysms. A technical case report.

Area of Science:

• Neurosurgery
• Interventional Radiology
• Medical Device Technology

Background:

• Oblong aneurysms present unique challenges for coil embolization due to the limitations of traditional helical or spherical coils.
• Conventional coils can be undersized in the long axis and oversized in the short axis of oblong aneurysms, leading to increased wall stress and re-rupture risk.

Observation:

• This study reviews three cases utilizing versatile filling coils (VFCs) as the primary embolic agent for oblong aneurysms.
• VFCs feature a flexible wave-loop structure that facilitates framing of irregularly shaped aneurysms, with loop portions conforming to the sac's extremes.
• The VFCs were smoothly introduced without catheter kickback, allowing for subsequent insertion of detachable filling coils and achieving complete aneurysm occlusion.

Findings:

• Complete occlusion without severe complications was achieved in all three cases.
• The average packing density after VFC implantation was 15.63%.
• The complex loop-wave design of VFCs allows for precise coil placement at the dome and neck, minimizing aneurysmal sac stress.

Implications:

• VFCs demonstrate a specific role in the initial framing of oblong aneurysms, offering a superior alternative to traditional coils.
• The use of VFCs may improve clinical outcomes by reducing complications associated with oblong aneurysm embolization.
• Further research into VFCs could optimize treatment strategies for complex cerebrovascular aneurysms.