Guidewire Introducer in a Y-connector Reduces Friction from the Delivery Wire during Coil Embolization of Cerebral Aneurysms

- In Vitro Evaluation

Abstract

Background and Purpose: Coil embolization is an effective and less invasive treatment of intracranial aneurysms and tight coil packing is important for avoiding recurrence due to coil compaction. However, tight coil packing increases resistance and the subsequent risk for aneurysmal rupture. We investigated the coil insertion pressure and the effectiveness of the adjunct use of a micro-guidewire introducer in the final stage of tight coil packing.
Methods: Using an in vitro model, we measured the chronologic changes in resistance to the insertion of 3 types of widely used finishing coils, namely, GDC-10 UltraSoft-, Micrus ULTIPAQ-, and ED coil-10 Extra Soft coils. We also measured the mechanical pressure to assess the effectiveness of the micro-guidewire introducer.
Results: At all but the first 1-cm interval, there were significant differences among the 3 coil types. Use of the introducer decreased the required insertion pressure by 25-30% when Micrus coils were placed (p < 0.001).
Conclusion: It is important to select the appropriate coil type at the final stage of coil embolization. A micro-guidewire introducer helps to decrease the insertion pressure.