Korean J Radiol.  2012 Aug;13(4):412-416. 10.3348/kjr.2012.13.4.412.

In Vitro Observation of Air Bubbles during Delivery of Various Detachable Aneurysm Embolization Coils

Affiliations
  • 1Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea. dhlee@amc.seoul.kr
  • 2Department of Radiology, Chung-Ang University College of Medicine, Seoul 156-861, Korea.

Abstract


OBJECTIVE
Device- or technique-related air embolism is a drawback of various neuro-endovascular procedures. Detachable aneurysm embolization coils can be sources of such air bubbles. We therefore assessed the formation of air bubbles during in vitro delivery of various detachable coils.
MATERIALS AND METHODS
A closed circuit simulating a typical endovascular coiling procedure was primed with saline solution degassed by a sonification device. Thirty commercially available detachable coils (7 Axium, 4 GDCs, 5 MicroPlex, 7 Target, and 7 Trufill coils) were tested by using the standard coil flushing and delivery techniques suggested by each manufacturer. The emergence of any air bubbles was monitored with a digital microscope and the images were captured to measure total volumes of air bubbles during coil insertion and detachment and after coil pusher removal.
RESULTS
Air bubbles were seen during insertion or removal of 23 of 30 coils (76.7%), with volumes ranging from 0 to 23.42 mm3 (median: 0.16 mm3). Air bubbles were observed most frequently after removal of the coil pusher. Significantly larger amounts of air bubbles were observed in Target coils.
CONCLUSION
Variable volumes of air bubbles are observed while delivering detachable embolization coils, particularly after removal of the coil pusher and especially with Target coils.

Keyword

Air bubble; Air embolization; Cerebral aneurysm; Embolization coil; Detachable coil

MeSH Terms

Embolism, Air/*etiology
Embolization, Therapeutic/*adverse effects/*instrumentation
Intracranial Embolism/*etiology
Magnetic Resonance Imaging/methods
Microscopy
Risk Assessment
Statistics, Nonparametric

Figure

  • Fig. 1 Closed circuit simulating patient's circulation and catheterization systems. (a) Pressure gauge, (b) silicone tube, (c) reservoir chamber, (d) peristaltic pump, (e) digital microscope and magnified view with small ruler for measurement, (f) guiding catheter, (g) microcatheter, (h) detachable coil and coil delivery system, and (i) pressurized saline bags.

  • Fig. 2 Pictures captured by digital microscope during delivery of MicroPlex coil (Hydrosoft 6 mm, 8 cm). A. Immediately after insertion of coil part. B. After detachment. C. Emergence of small air bubble (arrow) while removing pusher

  • Fig. 3 Pictures of air bubbles captured by digital microscope during delivery of Target coil system (2 mm, 4 cm). A. Air bubble is noted right after completion of coil insertion. B. Several small air bubbles are noted while detaching coil. C. Numerous air bubbles are seen after removal of pusher.

  • Fig. 4 Total volume of air bubbles emerging during delivery of each type of coil. Volume of air bubbles is significantly greater with Target coils than with other types.


Cited by  1 articles

Thromboembolic Events Associated with Electrolytic Detachment of Guglielmi Detachable Coils and Target Coils : Comparison with Use of Diffusion-Weighted MR Imaging
Myeong Jin Kim, Yong Cheol Lim, Se-yang Oh, Byung Moon Kim, Bum-soo Kim, Yong Sam Shin
J Korean Neurosurg Soc. 2013;54(1):19-24.    doi: 10.3340/jkns.2013.54.1.19.


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