Short-Segment Coil Embolization Using a Double-Balloon Technique in an Experimental Vascular Model

Abstract

PurposeTo evaluate the feasibility of short-segment coil embolization between 2 balloons for tight packing in an experimental vascular model.Materials and MethodsThree coil embolization techniques were performed by 5 interventional radiologists as follows: (1) proximal balloon technique (proximal BT) which involved proximal balloon inflation and coil deployment over the balloon, (2) distal balloon technique (distal BT) which involved distal balloon inflation and coil deployment at the proximal side of the inflated balloon, and (3) double-balloon technique (DBT) which involved coil deployment between 2 inflated balloons. We used a 10-mm-diameter and 200-mm-long hydrocoil. The distance between the 2 inflated balloons was set at 5 mm in the perfused tube, and each procedure was performed twice. The longitudinal lengths of the deployed coil mass and volume embolization rates (VERs) at the embolization site obtained using the 3 techniques were compared statistically.ResultsThe longitudinal lengths of the deployed coil mass were 26 mm (range, 21–34 mm), 10 mm (8–14 mm), and 5 mm (5–5 mm) in proximal BT, distal BT, and DBT, respectively. The median VERs were 15.9% (12.2–19.4%), 41.4% (29.6–51.8%), and 82.9% (82.9–82.9%), respectively. Significant differences in the lengths and VERs were observed among the 3 techniques (p < 0.001).ConclusionDBT achieved the tight packing of a hydrocoil in a short segment of an experimental vascular model compared with proximal BT and distal BT, suggesting DBT as the optimal embolization technique in this model.

Target Coil Embolization Using the Combined Transarterial and Transvenous Balloon-assisted Technique for Traumatic Direct Carotid Cavernous Fistula

“…However, it is thought that the transvenous balloon-assisted technique is useful when coil migration to the frame outside is considerable. Short-segment coil embolization using double balloon technique in an experimental vascular model has been reported, 19) and we performed double balloon technique with reference to it. Moreover, finishing coils migrate easily to the ICA; thus, transarterial balloon is slightly overinflated.…”

Ultrashort-Segment Embolization of High-Flow Vessels Using a Coil Packing Technique in an Amplatzer Vascular Plug

“…Short-segment embolization is a relatively difficult procedure, and various techniques have been reported. 1–4 Yunaiyama et al 1 used a double-balloon technique in an experimental model; however, coil embolization is associated with a risk of coil migration in high-flow vessels, and more stable embolization methods are needed, such as a microvascular plug. Koganemaru et al 4 reported an internal coil packing method for a mesh occlusion device, which is similar to our procedure.…”

“…Ultrashort-segment embolization is a highly useful technique [1][2][3][4] ; however, its application in large-diameter target vessels is very difficult because the flow through these vessels is very high. The Amplatzer Vascular Plug 1 (AVP1; Abbott Vascular, Redwood City, CA, USA) is one of the best devices for short-segment embolization, but vessel occlusion can be delayed or fail altogether under certain circumstances, especially in the presence of antiplatelet and/or anticoagulation therapy.…”

Coil Embolisation for Endovascular Treatment of Proper Hepatic Artery Aneurysm Using the Balloon Occlusion Technique

“…This method can embolise the target artery more tightly and compactly than the proximal balloon occlusion technique. 5 As a result, it also prevented occlusion of the collateral branch that supplies blood flow distally. 2 Also, the original 4.5 Fr guiding sheath system was used, so only a single approach via the right femoral artery was required.…”