Ota Keisuke, Matsubara Noriaki, Miyachi Shigeru, Izumi Takashi, Ito Masashi, Asai Takumi, Yamanouchi Takashi, Wakabayashi Toshihiko
1 Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan.
2 Department of Neurosurgery & Neuroendovascular Therapy, Osaka Medical College, Takatsuki, Japan.
Interv Neuroradiol. 2017 Apr;23(2):143-150. doi: 10.1177/1591019916685713. Epub 2017 Jan 17.
In endovascular coil embolization of intracranial aneurysms, very soft coils, often called "finishing coils," are usually selected in the final stage of coil embolization. The authors developed a radiolucent coil made of thin nylon thread to evaluate the performance of coils under a situation simulating the course of embolization. The characteristics of various types of finishing coils were investigated using radiolucent coils. Experimental embolization was performed with a silicone aneurysm filled with radiolucent coils simulating the final stage of embolization. Three indices, i.e. area, perimeter, and circularity of the inserted coils, were investigated on the X-ray images after coil insertion. The coils used were as follows: Target Ultra Helical, MicroPlex Hypersoft, Axium Helix, ED Coil Extrasoft, and DeltaPlush. In the analysis of area and perimeter, there were significant differences in multiple comparisons. There was no significant difference in circularity, although it was generally ranked in order by coil brand. Target Ultra and MicroPlex Hypersoft had higher scores for area and perimeter and lower scores for circularity, in contrast to DeltaPlush, which had lower scores for area and perimeter and a higher score for circularity. Based on these results, the finishing coils were divided into three groups: Target Ultra Helical and MicroPlex Hypersoft; Axium Helix and ED Coil Extrasoft; DeltaPlush. They are better for use in early, midst, and end of finishing, respectively. The characteristics of various finishing coils were evaluated, and the results obtained reflected actual clinical experience and provide useful information to appropriately select finishing coils.
在颅内动脉瘤的血管内弹簧圈栓塞术中,通常在弹簧圈栓塞的最后阶段选用非常柔软的弹簧圈,常被称为“收尾弹簧圈”。作者开发了一种由细尼龙线制成的可透射线弹簧圈,以评估在模拟栓塞过程的情况下弹簧圈的性能。使用可透射线弹簧圈研究了各种类型收尾弹簧圈的特性。用填充有可透射线弹簧圈的硅胶动脉瘤模拟栓塞的最后阶段进行实验性栓塞。在弹簧圈插入后的X线图像上研究了插入弹簧圈的三个指标,即面积、周长和圆形度。所用的弹簧圈如下:Target Ultra Helical、MicroPlex Hypersoft、Axium Helix、ED Coil Extrasoft和DeltaPlush。在面积和周长分析中,多重比较存在显著差异。圆形度方面没有显著差异,尽管通常按弹簧圈品牌排序。与DeltaPlush相比,Target Ultra和MicroPlex Hypersoft的面积和周长得分较高,圆形度得分较低,而DeltaPlush的面积和周长得分较低,圆形度得分较高。基于这些结果,收尾弹簧圈分为三组:Target Ultra Helical和MicroPlex Hypersoft;Axium Helix和ED Coil Extrasoft;DeltaPlush。它们分别更适合在收尾的早期、中期和末期使用。评估了各种收尾弹簧圈的特性,所获得的结果反映了实际临床经验,并为适当选择收尾弹簧圈提供了有用信息。