Commentary: Coil Packing Density – Not Just for Cerebral Aneurysms

Abstract

Coil packing density (CPD) has been recognized as a factor related to coil compaction or recanalization in the treatment of visceral and intracranial aneurysms ( 1 Yasumoto T. Osuga K. Yamamoto H. et al. Long-term outcomes of coil packing for visceral aneurysms: correlation between packing density and incidence of coil compaction or recanalization. J Vasc Interv Radiol. 2013; 24: 1798-1807 Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar , 2 Kawanabe Y. Sadato A. Taki W. Hashimoto N. Endovascular occlusion of intracranial aneurysms with Guglielmi detachable coils: correlation between coil packing density and coil compaction. Acta Neurochir (Wien). 2001; 143: 451-455 Crossref PubMed Scopus (186) Google Scholar ). Simple coiling (SC), balloon remodeling (BR), and stent-assisted coiling are 3 commonly used techniques for percutaneously treating aneurysms. In the article by Kesim et al ( 3 Kesim Ç. Özcan Ü.C. Yildirim E. Effects of the cerebral aneurysm treatment method on coil packing density and its relationship with the ostium area. J Vasc Interv Radiol. 2022; 33: 631-638 Abstract Full Text Full Text PDF Scopus (1) Google Scholar ) titled “Effects of the Aneurysm Treatment Method on Coil Packing Density and Its Relationship with the Ostium Area,” the authors demonstrated that it is possible to achieve similar CPDs using these 3 coiling techniques while treating intracranial aneurysms and concluded that “in cerebral aneurysms treated with balloon- or stent-assisted coiling, the CPD value does not differ from that in aneurysms treated with simple coiling.” The authors noted that coiling technique is influenced by aneurysm neck size, with BR and stent-assisted coiling used for aneurysms with unfavorable neck morphology. Another possible conclusion is that for aneurysms with unfavorable neck morphology, BR and stent-assisted coiling make it possible to achieve CPDs similar to those achieved with SC in “simple” aneurysms. Effects of the Cerebral Aneurysm Treatment Method on Coil Packing Density and Its Relationship with the Ostium AreaJournal of Vascular and Interventional RadiologyVol. 33Issue 6PreviewTo test the following hypotheses: (a) balloon or stent assistance increases coil packing density (CPD) in the endovascular treatment of intracranial aneurysms, and (b) CPD correlates to ostium area (OA) and aneurysm volume (AV). Full-Text PDF