Aneurysm permeability following coil embolization: packing density and coil distribution

Area of Science:

• Biomedical Engineering
• Medical Imaging
• Neurosurgery

Background:

• Aneurysm occlusion rates after coil embolization vary, necessitating a deeper understanding of coil mass mechanics.
• Current methods lack precise quantification of factors influencing coil mass behavior.

Purpose of the Study:

• To evaluate the impact of packing density and coil uniformity on aneurysm permeability.
• To identify key parameters for optimizing coil embolization outcomes.

Main Methods:

• Aneurysm models were embolized using Guglielmi detachable coils and Target coils.
• Permeability was assessed using microsphere passage, and coil mass uniformity was analyzed via imaging.
• Multivariate regression models were employed to correlate packing density and uniformity with permeability.

Main Results:

• Packing density, dome/neck surface area fraction, and dome uniformity were significantly correlated (p<0.05).
• Permeability was better predicted using both packing and uniformity measures (r(2)=0.73) compared to packing density alone (r(2)=0.45).
• Coil distribution uniformity in the dome is crucial for accurate permeability prediction.

Conclusions:

• Dense packing and high coil mass uniformity are essential for reducing aneurysm permeability.
• Optimizing coil uniformity alongside packing density can improve durable aneurysm occlusion.