Neurointervention.  2024 Mar;19(1):31-38. 10.5469/neuroint.2024.00031.

In Vitro Head-to-Head Comparison of Flow Reduction between Fibered and Non-Fibered Pushable Coils

• Yoon JT
• Kwon B
• Choi JH
• Hwang SM
• Kim M
• Hwang S
• Song Y
• Lee DH

• KMID: 2552877
• DOI: http://doi.org/10.5469/neuroint.2024.00031

Abstract

Purpose
To compare the embolization effects of a non-fibered pushable coil with a conventional fibered pushable coil in an in vitro bench-top experiment.
Materials and Methods
A simplified vascular phantom with 4 channels (1 for the non-fibered coil, 1 for the fibered coil, and 2 for continuous circuit flow) was used. A single coil of the longest length was inserted to evaluate the effect of single-coil embolization, and 3 consecutive coils were inserted to assess the effect of multiple-coil embolization. Post-embolization angiography was performed to obtain flow variables (time to peak [TTP], relative peak intensity [rPI], and angiographic flow reduction score [AFRS]) from time density curves. The packing densities of the two coil types were calculated, and the AFRS of each channel was determined by dividing the TTP by the rPI.
Results
When inserting a single coil, the conventional fibered coil demonstrated better flow reduction, as indicated by a higher AFRS (25.6 vs. 17.4, P=0.034). However, the non-fibered coil exhibited a significantly higher packing density (12.9 vs. 2.4, P=0.001). Similar trends were observed with multiple coils.
Conclusion
The conventional fibered pushable coil showed better flow reduction efficiency, while the non-fibered pushable coil had a higher packing density, likely due to the flexibility of the coil loops. A better understanding of the distinct characteristics of different pushable coils can enhance the outcomes of various vascular embolization.

Keyword

Embolization; Coils; Angiography; Flow rate; Packing density

Figure

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  Fig. 1. Photographs of the (A) non-fibered and (B) fibered embolization coils used in this study.

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  Fig. 2. Illustration of a flow and a contrast injection system. (A) Vascular phantom, (B) guiding catheter, (C) microcatheter, (D) automated power injector, (E) pulsatile pump, (F) large-volume drain container, (G) silastic tube, (H) stopcock, (I) hemostatic valve.

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  Fig. 3. Vascular phantom model post-processed with iFlow (A) and time density curve obtained with iFlow (B). REF, reference.

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  Fig. 4. Results of multiple coil embolization. (A) Time to peak, (B) maximum intensity, (C) relative intensity, (D) angiographic flow reduction score (AFRS), (E) packing density.

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