Journal Article Optimizing the Volume of the Initial Framing Coil to Facilitate Tight Packing of Intracranial Aneurysms

Misaki, Kouichi  ,  Uchiyama, Naoyuki  ,  Nambu, Iku  ,  Aida, Yasuhiro  ,  Kamide, Tomoya  ,  Mohri, Masanao  ,  Ueda, Fumiaki  ,  Nakada, Mitsutoshi

90pp.397 - 402 , 2016-06-01 , Elsevier
Background: During endovascular treatment of an aneurysm, the importance of the initial coil volume for facilitating tight packing is unclear. We retrospectively studied the relationships between initial packing density (PD; initial coil volume divided by aneurysm volume), final PD (volume of all coils divided by aneurysm volume). Methods: We reviewed 105 aneurysms in 98 patients who underwent endovascular coiling between April 2011 and March 2014. The initial coil was defined as the first coil in the single-catheter method and the first 2 coils in the double-catheter method. The patient data were divided into groups with or without a final PD ≥20%, and the significant predictors of a final PD ≥20% were determined using multivariable logistic regression. The optimal cutoff value for the initial PD was determined using a receiver operating characteristic curve. Results: Of 105 aneurysms, 56 and 49 were treated with single- and double-catheter methods, respectively. Statistically significant differences in rupture status, neck size, dome/neck ratio, and initial PD were observed between aneurysms with and without a final PD ≥20% (all P < 0.05). Multivariate analysis showed that initial PD (P = 0.025; odds ratio, 1.22) and rupture status (P = 0.002; odds ratio, 0.19) were significantly associated with a final PD ≥20%. Using receiver operating characteristic curve analysis, the cutoff points of initial PD to achieve a final PD ≥20% were 8.0% and 10.0% in single- and double-catheter groups, respectively. Conclusions: Initial PD appears to be a critical factor for achieving tight packing. © 2016 Elsevier Inc. All rights reserved.
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