The impact of coil shape design on angiographic occlusion, packing density and coil mass uniformity in aneurysm embolization: An in vitro study

Manik Mehra, Michael C. Hurley, Matthew J. Gounis, Robert M. King, Ali Shaibani, Guilherme Dabus, Fatimaezzahra E. Labdag, Elad I. Levy, Bernard Bendok

Research output: Contribution to journalArticle

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Abstract

Objective: To investigate the impact of coil design on the distribution of the coil mass in a controlled in vitro experiment. A secondary objective was to study the relationship between angiographic occlusion, packing density and coil mass uniformity. Methods: Seven silicon side wall aneurysm models were embolized in each arm with a different coil design under fluoroscopic guidance. Packing density calculations and scoring of the angiographic occlusion were made. The models were embedded in epoxy and sectioned through the aneurysm neck and the dome. The sections were imaged and processed to derive the fractional surface area of coil material over the coil free area, a quantitative endpoint representing the percentage of the given region of interest consumed by coils. The SD of the surface area fractions is inversely proportional to the uniformity of coil distribution. Results: The novel triangular primary wind design of the Deltapaq achieved a more homogenous distribution of coils within the aneurysm dome compared with the helical and complex microcoil systems (p=0.018). The packing density achieved by the Deltapaq (39.1±1.6%) was significantly higher than the complex (35.2±2.8%) and the helical (32.2±3.3%) coils. Angiographically, aneurysms coiled by the Deltapaq were more likely to obtain a Raymond score of class I. Conclusion: Evaluation of emerging coil technologies with respect to treatment durability may be well served by an assessment of their uniformity of distribution within an aneurysm in addition of the traditional packing density and angiographic occlusion scoring methods.

Original languageEnglish (US)
Pages (from-to)131-136
Number of pages6
JournalJournal of NeuroInterventional Surgery
Volume3
Issue number2
DOIs
StatePublished - Jun 2011
Externally publishedYes

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Aneurysm
Silicon
Research Design
In Vitro Techniques
Technology

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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The impact of coil shape design on angiographic occlusion, packing density and coil mass uniformity in aneurysm embolization : An in vitro study. / Mehra, Manik; Hurley, Michael C.; Gounis, Matthew J.; King, Robert M.; Shaibani, Ali; Dabus, Guilherme; Labdag, Fatimaezzahra E.; Levy, Elad I.; Bendok, Bernard.

In: Journal of NeuroInterventional Surgery, Vol. 3, No. 2, 06.2011, p. 131-136.

Research output: Contribution to journalArticle

Mehra, Manik ; Hurley, Michael C. ; Gounis, Matthew J. ; King, Robert M. ; Shaibani, Ali ; Dabus, Guilherme ; Labdag, Fatimaezzahra E. ; Levy, Elad I. ; Bendok, Bernard. / The impact of coil shape design on angiographic occlusion, packing density and coil mass uniformity in aneurysm embolization : An in vitro study. In: Journal of NeuroInterventional Surgery. 2011 ; Vol. 3, No. 2. pp. 131-136.
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abstract = "Objective: To investigate the impact of coil design on the distribution of the coil mass in a controlled in vitro experiment. A secondary objective was to study the relationship between angiographic occlusion, packing density and coil mass uniformity. Methods: Seven silicon side wall aneurysm models were embolized in each arm with a different coil design under fluoroscopic guidance. Packing density calculations and scoring of the angiographic occlusion were made. The models were embedded in epoxy and sectioned through the aneurysm neck and the dome. The sections were imaged and processed to derive the fractional surface area of coil material over the coil free area, a quantitative endpoint representing the percentage of the given region of interest consumed by coils. The SD of the surface area fractions is inversely proportional to the uniformity of coil distribution. Results: The novel triangular primary wind design of the Deltapaq achieved a more homogenous distribution of coils within the aneurysm dome compared with the helical and complex microcoil systems (p=0.018). The packing density achieved by the Deltapaq (39.1±1.6{\%}) was significantly higher than the complex (35.2±2.8{\%}) and the helical (32.2±3.3{\%}) coils. Angiographically, aneurysms coiled by the Deltapaq were more likely to obtain a Raymond score of class I. Conclusion: Evaluation of emerging coil technologies with respect to treatment durability may be well served by an assessment of their uniformity of distribution within an aneurysm in addition of the traditional packing density and angiographic occlusion scoring methods.",
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