Efficacy of a 14-coil for Framing in Coil Embolization of Small Cerebral Aneurysms

Abstract

The purpose of this study was to demonstrate the efficacy of a 14-coil (Target XL) for framing in coil embolization of small cerebral aneurysms. Methods: Between January 2017 and December 2018, 46 patients underwent coil embolization of a small cerebral aneurysm that was less than 5 mm in maximum diameter. They were categorized into 26 patients in whom only 10-coils were used and 20 in whom Target XL was used for framing. The volume embolization rate (VER) and recanalization rate were compared between the two groups. Results: Although there were two patients in whom Target XL was replaced with a 10-coil for framing, no adverse events associated with the use of Target XL were noted. The mean VER of the first framing coil was significantly higher in aneurysms that were framed with Target XL than in those framed with a 10-coil (Target XL 22.6 ± 4.5%, 10-coil 17.9 ± 8.4%; p = 0.03). Furthermore, the mean VER at the end of the procedure was significantly higher in aneurysms with Target XL used for framing than in those embolized using only 10-coils (14-coil: 36.8 ± 7.8%, 10-coil: 32.0 ± 6.5%; p = 0.03). No recanalization was observed in aneurysms for which Target XL was used for framing, whereas five aneurysms embolized using only 10-coils were recanalized. Conclusion: Target XL may be safe and feasible as a framing coil in coil embolization of small cerebral aneurysms, which may result in a high VER, low recanalization rate, and good outcome.

Intermediate catheter use is associated with complete occlusion and dense packing in coil embolization of unruptured cerebral aneurysms: a propensity score matched study

“…14 For large coils, aneurysms embolized with 14-coil Target XL (Stryker Neurovascular) with a primary diameter of 0.014 inches had a significantly higher mean VER at the end of the procedure than aneurysms embolized with a 10-coil with a primary diameter of 0.010 inches (14 coil: 36.8% (SD 7.8%) vs 10 coil: 32.0% (SD 6.5%), P=0.03). 15 Even after adjusting for such confounding factors with propensity score matching, the present study revealed that the use of an IMC in a triaxial system for coil embolization of UCAs can increase the percent of complete occlusion immediately after treatment and 6 months after treatment and achieve dense coil packing. Furthermore, an IMC did not increase postoperative ischemic and hemorrhagic complications and IMC-related parent artery dissection.…”

“…The following data were obtained by retrospectively reviewing the medical records and radiological data of these patients: age, sex, medical history, family history of cerebral aneurysms, smoking and drinking history, aneurysm characteristics, intermediate catheter used, endovascular technique (balloon-assisted, stent-assisted), type of coils (bioactive coils, 13 hydrogel coils, 14 or large coils with a primary diameter of 0.014 inches or larger 15 ), period of treatment (early: 2003-2013, late: 2014-2023), embolization result, and complications. All aneurysms were analyzed for morphology using rotational angiography with three-dimensional image reconstruction (The Jikei University Hospital: Artis Q Biplane, Siemens Healthcare GmbH, Forchheim, Germany; Kashiwa Hospital: Artis zee BA Twin Large Display.…”

“…More operable IMCs were invented more recently, 1 3 4 6 and in the present study, the group with an IMC was treated significantly more frequently in the late period (2014-2023) than the group without an IMC. However, the two groups were compared by propensity score matching adjusted for the adjunctive techniques (balloon-assisted 20 and stent-assisted 21 ), the type of coils (bioactive coils, 13 hydrogel coils, 14 and large coils 15 ), and the period of treatment (early: 2003-2013, late: 2014-2023), which might affect the rate of complete occlusion, packing density, and re-treatment rate in coil embolization for UCAs.…”

Small Number of Coils With Extended Length in the Endovascular Treatment of Cerebral Aneurysm: Experience of 108 Cases in a Single-Center

“…The number of coils needed in the endovascular treatment of aneurysms is influenced by several factors, such as coil length, thickness, type, aneurysmal shape, as well as operator's skill and experience [7,15]. Endovascular treatment with larger coils can prevent failure in the complete occlusion of aneurysms, and a stiffer framing coil or a larger coil diameter can help prevent aneurysm recanalization [16,17]. The percentage of framing coil from total coil volume has been demonstrated to be a statistically significant predictor of aneurysm recurrence post-coiling [18].…”