Coils embolization use for coronary procedures: Basics, indications, and techniques

Abstract

The use of coils is fundamental in interventional cardiology and can be lifesaving in selected settings. Coils are classified by their materials into bare metal, fiber coated, and hydrogel coated, or by the deliverability method into, pushable or detachable coils. Coils are delivered through microcatheters and the choice of coil size is important to ensure compatibility with the inner diameter of the delivery catheter, firstly to be able to deliver and secondly to prevent the coil from being stuck and damaged. Clinically, coils are used in either acute or in elective setting. The most important acute indication is typically the sealing coronary perforation. In the elective settings, coils can be used for the treatment of certain congenital cardiac abnormalities, aneurysms, fistulas or in the treatment of arterial side branch steal syndrome after CABG. Coils must always be delivered under fluoroscopy guidance. There are some associated complications with coils that can be acute or chronic, that nictitates regular followed‐up. There is a need for education, training and regular workshops with hands‐on to build the experience to use coils in situations that are infrequently encountered.

Conquer coronary artery perforation with magic hands

“…Coil, subcutaneous fat, autologous skin, autologous blood clots, thrombin, microspheres, collagen, gelatin sponge, polyvinyl alcohol particles, balloon fragments or the tip of wires may be used for distal embolization. [22][23][24] Commonly used delivery devices include thrombus aspiration catheters, over-the-wire (OTW) balloons or microcatheters. Microcatheters and OTW balloons are recommended to deliver embolic substances for more precise placement.…”

What Device is Seen in the Chest X-Ray?

“…Elective indications include occlusion of aneurysms or pseudoaneurysms, occlusion of coronary AVM, branch occlusion to prevent coronary artery steal, occlusion of saphenous vein grafts following native artery percutaneous coronary intervention, and certain congenital cardiac conditions such as small patent ductus arteriosus or aortopulmonary collaterals. [ 5 ] Based on the material and coating, coils can be classified into three categories: (i) bare metal (platinum or nitinol based) coils, (ii) hydrogel-coated coils, and (iii) fibered coils. The complications related to coronary coils can be acute or chronic.…”