Enhancing Precision in Vascular Embolization: Evaluating the Effectiveness of the Intentional Early Detachment Technique with Detachable Coils in Complex Cases

Abstract

Background This study aimed to assess the effectiveness and versatility of an intentional early detachment technique with detachable coils to address challenging vascular embolization scenarios. This novel approach aims to provide interventional radiologists with an alternative method for achieving precise coil placement when standard methods of detachable coil placement are rendered ineffective owing to vascular anatomy or limited available equipment. Materials and Methods This was a retrospective study comprising 11 patients (9 males and 2 females; median age, 77 years) who underwent embolization procedures using the intentional early detachment technique via 1.6-Fr or 1.3-Fr microcatheters between October 2021 and December 2023. In this technique, detachable coils were intentionally detached within the microcatheter and placed using saline flushing. Technical success, complications, and clinical success were evaluated. Results The technique was applied in three distinct scenarios: tortuous vascular anatomy (4 cases), inadequate system backup (3 cases), and 1.3-Fr microcatheter use (4 cases). The technical and clinical success rates were 100%. No complications were observed, and there were no cases of coil migration or malpositioning. Conclusion The intentional early detachment technique is valuable for interventional radiologists and offers a solution for challenging vascular embolization scenarios. Although its application is limited to specific circumstances, it can significantly enhance coil placement in complex cases, thereby contributing to improved patient care.