3:18 PM Abstract No. 304 How peripheral embolic coil design differences affect embolic efficacy

Abstract

Embolic coils have been used for peripheral embolization since the 1970s with many commercially available designs. However, coil design differences relating to embolization efficacy is not well understood. We aim to test some of the variables used in commercially available coils, including coil size, fiber, fiber material, and expanding gel and compare how these differences affect embolic efficacy using a swine model. Paired arteries were selected and embolized utilizing 2 protocols. Standard clinical embolization practice and flow scoring (TIMI grading) was employed across the study. The first protocol contained two groups; Dacron fiber coil (Interlock 18 Bos. Sci.) vs. nylon/PGLA coil (Concerto Covidien) and Dacron fiber coil (Interlock 18) vs. hydrogel coil (Azur Terumo). Selected arteries fit predetermined size and configuration criteria. The second protocol contained a single group comparing fibered 0.018 coils vs. nonfibered (fibered & nonfibered interlock 18) and compared the effect on coil diameter (Interlock 18 vs. Interlock 35); similar single arteries were selected with three treatment areas. Paired arteries (3) were occluded in each animal and 6 sets were occluded for each group. Occlusion efficiency was assessed by the number of coils used, unit length of coils and the amount of time required for complete embolization. Average occlusion time was quickest for the Interlock 18 and 35, both at mean time of 10.7 min. The Interlock 18 used less coils (mean # of coils 2.9 vs 3.5) and unit length of coil (50.3 and 65.0 cm). The longest mean occlusion time was for the Azur at 19.4 mins and utilizing an average of 4.8 coils and 95.2 cm unit length. Most efficacious was Interlock 18, which was 47% better in embolization time and 48% better in mean coil length for complete embolization, than the least, the Azur. On average, coils with fiber had shorter occlusion time than those without (10.7 vs. 15.3 mins) and utilized less coils (2.9 vs. 4.2). Fibered coils, specifically Dacron fibers, have an improved embolization efficacy over those without fiber (and hydrogel) as measured by embolization time, number of coils, and unit length of coil used in an animal model.