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Yamaguchi S, Horie N, Hayashi K, Fukuda S, Morofuji Y, Hiu T, Izumo T, Morikawa M, Matsuo T. Point-by-point parent artery/sinus obliteration using detachable, pushable, 0.035-inch coils. Acta Neurochir (Wien) 2016; 158:2089-2094. [PMID: 27586124 DOI: 10.1007/s00701-016-2946-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 08/24/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parent artery occlusion for intractable aneurysms or sinus packing for dural arteriovenous fistulas (DAVFs) is sometimes difficult and requires many expensive coils to accomplish complete occlusion. To help solve these problems, we reviewed our experience using 0.035-inch coil (0.035 coil; Boston Scientific, San Leandro, CA, USA), which has been used in cardiovascular and abdominal lesions. METHODS These 0.035 coils were preferably used in addition to the detachable and fibered coils for patients with intractable aneurysms, traumatic vessel blowout, and DAVF. Our strategy was as follows: (1) detachable coils were deployed first for the ideal anchoring of the coils; (2) small fibered coils were additionally deployed to stabilize the coil mass; (3) 0.035 coils were deployed to complete the occlusion. RESULTS From January 2012 to December 2013, seven consecutive patients were treated by endovascular embolization with 0.035 coils. Reasons for intervention were parent artery occlusion for carotid blowout (n = 1), internal carotid artery aneurysm (n = 2), traumatic vertebral artery injury (n = 2), vertebral AVF (n = 1), and transverse sinus-sigmoid sinus DAVF (n = 1). In our cases, a mean of 20.1 ± 8.5 coils per vessel were placed, and mean total coil length was 258.4 ± 91.5 cm per vessel. All procedures were safely performed and complete occlusions achieved. CONCLUSIONS From our initial experience and treatment results, we believe endovascular parent artery occlusion or sinus packing with 0.035 coils to be useful in terms of reducing the number and expense of coils and also accomplishing immediate occlusion.
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Affiliation(s)
- Susumu Yamaguchi
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1, Sakamoto, Nagasaki, Japan, 852-8501.
| | - Nobutaka Horie
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1, Sakamoto, Nagasaki, Japan, 852-8501
| | - Kentaro Hayashi
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1, Sakamoto, Nagasaki, Japan, 852-8501
| | - Shuji Fukuda
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1, Sakamoto, Nagasaki, Japan, 852-8501
| | - Yoichi Morofuji
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1, Sakamoto, Nagasaki, Japan, 852-8501
| | - Takeshi Hiu
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1, Sakamoto, Nagasaki, Japan, 852-8501
| | - Tsuyoshi Izumo
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1, Sakamoto, Nagasaki, Japan, 852-8501
| | - Minoru Morikawa
- Department of Radiological Science, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1, Sakamoto, Nagasaki, Japan, 852-8501
| | - Takayuki Matsuo
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1, Sakamoto, Nagasaki, Japan, 852-8501
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Hayashi K, Horie N, Morikawa M, Nagata I. Usefulness of C-stopper coil for neurointervention. Neurol Med Chir (Tokyo) 2014; 54:450-6. [PMID: 24477060 PMCID: PMC4533448 DOI: 10.2176/nmc.oa.2013-0154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
C-stopper coil (CSC) which are available for 0.018-inch inner diameter microcenter have been used for neurointervention such as transarterial embolization (TAE) of feeding artery. Although various shapes of pushable microcoils have been developed, microcoils are usually short to embolize the lesion and require lots of coils. The most specific feature of CSC is the extended length of 18 cm. To evaluate the usefulness of CSC, we reviewed our experience of CSC. Neurointervention using CSC was performed for 28 patients (31 treatments). Intervention procedures were TAE for dural arteriovenous fistula (AVF)(n = 15), transvenous embolization for dural AVF (n = 4), parent artery occlusion for cerebral aneurysm, dissection and carotid-cavernous fistula (n = 8), TAE for epistaxis (n = 2), and preoperative embolization for tumor (n = 2). CSCs were deployed with push technique through microcatheter. CSCs were successfully placed into the lesion namely feeding artery, venous sinus, parent artery of aneurysm, or dissection. There were no major technical complications resulting in morbidity. Postoperative course was uneventful. No recanalization of the occluded vessel occurred during follow-up. Use of CSCs was safe and feasible for embolization of cerebrovascular lesion.
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Affiliation(s)
- Kentaro Hayashi
- Department of Neurosurgery, Nagasaki University School of Medicine
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