In vitro measurement of the permeability of endovascular coils deployed in cerebral aneurysms

Sadasivan, Chander; Swartwout, Erica; Kappel, Ari D.; Woo, Henry H.; Fiorella, David; Lieber, Baruch B.

doi:10.1136/neurintsurg-2017-013481

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…[9] A higher permeability of the PC400 has been described previously in an in vitro model of an 8 mm aneurysm when compared to other coils. [16] Only Kaesmacher et al reported an immediate 3A/3B mRROC in 29.7% of cases. [6] Nevertheless, at follow-up, we demonstrate that the proportion of a good obliteration rate increased significantly (24 out of 26 cases: 92%), especially in unruptured aneurysms (100% of the cases).…”

Section: Discussionmentioning

confidence: 96%

Endovascular treatment of medium and large intracranial aneurysms with large volume coils: A single-center experience

Saal‐Zapata

Ghodke

Walker

et al. 2022

Surgical Neurology International

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Background: Large volume coils are an alternative to conventional coils for the treatment of intracranial aneurysms. However, there are no published reports documenting occlusion and complication rates in medium and large intracranial aneurysms. Therefore, we present our results in this subgroup of aneurysms. Methods: A single-center, retrospective analysis of consecutive patients treated with Penumbra coils 400 in aneurysms ≥7 mm was performed. Demographics, aneurysm features, procedural details, intraoperative complications, clinical outcomes, and occlusion rates were analyzed. Results: Thirty-three patients were included for analysis, and a total of 33 intracranial aneurysms were analyzed. Mean age was 57.6 years (SD ± 12.4) and 85% of the patients were women. Large aneurysms represented 46% of cases. Paraclinoid (55%) followed by posterior communicating (30.3%) aneurysms was the most frequently treated. Ruptured and saccular aneurysms were found in 49% and 63% of the cases, respectively. The mean aneurysmal dimensions were 14.2 mm width, 11.9 mm length, 5.4 mm neck, and 2.4 dome-to-neck ratio. A dome-neck ratio <2 was identified in 39% of cases. The mean number of coils per aneurysm was 4.8. Immediate modified Raymond–Roy Grades 1, 2, and 3A were achieved in 15%, 21%, and 64%, respectively. Twenty-six patients were evaluated at a mean follow-up period of 11 months, with an adequate occlusion of 92% and a good clinical outcome (modified Rankin score ≤2) in 96% of patients. Conclusion: Endovascular treatment with PC400 coils is an effective and safe option for medium and large intracranial aneurysms with high occlusion rates, few complications, and good clinical outcomes at follow-up.

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Section: Discussionmentioning

confidence: 96%

Endovascular treatment of medium and large intracranial aneurysms with large volume coils: A single-center experience

Saal‐Zapata

Ghodke

Walker

et al. 2022

Surgical Neurology International

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“…Being deployed into the IA sac, coils create a three-dimensional porous medium with varying pore sizes and shapes [19]. Because 3D coil configuration (and thus the pore spaces around the coils) cannot be obtained from imaging, we used 2 surrogate metrics defined in 2D to characterize and quantify coil distribution on the phantom cross-sections.…”

Section: Methodsmentioning

confidence: 99%

Improving accuracy for finite element modeling of endovascular coiling of intracranial aneurysm

et al. 2019

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BackgroundComputer modeling of endovascular coiling intervention for intracranial aneurysm could enable a priori patient-specific treatment evaluation. To that end, we previously developed a finite element method (FEM) coiling technique, which incorporated simplified assumptions. To improve accuracy in capturing real-life coiling, we aimed to enhance the modeling strategies and experimentally test whether improvements lead to more accurate coiling simulations.MethodsWe previously modeled coils using a pre-shape based on mathematical curves and mechanical properties based on those of platinum wires. In the improved version, to better represent the physical properties of coils, we model coil pre-shapes based on how they are manufactured, and their mechanical properties based on their spring-like geometric structures. To enhance the deployment mechanics, we include coil advancement to the aneurysm in FEM simulations. To test if these new strategies produce more accurate coil deployments, we fabricated silicone phantoms of 2 patient-specific aneurysms in duplicate, deployed coils in each, and quantified coil distributions from intra-aneurysmal cross-sections using coil density (CD) and lacunarity (L). These deployments were simulated 9 times each using the original and improved techniques, and CD and L were calculated for cross-sections matching those in the experiments. To compare the 2 simulation techniques, Euclidean distances (dMin, dMax, and dAvg) between experimental and simulation points in standardized CD-L space were evaluated. Univariate tests were performed to determine if these distances were significantly different between the 2 simulations.ResultsCoil deployments using the improved technique agreed better with experiments than the original technique. All dMin, dMax, and dAvg values were smaller for the improved technique, and the average values across all simulations for the improved technique were significantly smaller than those from the original technique (dMin: p = 0.014, dMax: p = 0.013, dAvg: p = 0.045).ConclusionIncorporating coil-specific physical properties and mechanics improves accuracy of FEM simulations of endovascular intracranial aneurysm coiling.

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A New Method for Simulating Embolic Coils as Heterogeneous Porous Media

Yadollahi-Farsani

Herrmann

Chong

2018

Cardiovasc Eng Tech

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In vitro measurement of the permeability of endovascular coils deployed in cerebral aneurysms

Cited by 4 publications

References 31 publications

Endovascular treatment of medium and large intracranial aneurysms with large volume coils: A single-center experience

Endovascular treatment of medium and large intracranial aneurysms with large volume coils: A single-center experience

Improving accuracy for finite element modeling of endovascular coiling of intracranial aneurysm

A New Method for Simulating Embolic Coils as Heterogeneous Porous Media

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