scholarly journals Technical Note on VDS

2002 ◽  
Vol 8 (2) ◽  
pp. 197-200 ◽  
Author(s):  
H. Henkes ◽  
P. Drepper ◽  
J. Speder ◽  
S. Felber ◽  
H. Monstadt ◽  
...  
Keyword(s):  
Stainless Steel ◽  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Technical Note ◽  
Coil Occlusion ◽  
Platinum Coil ◽  
Continuous Current ◽  
Detachment Time ◽  
Platinum Coils ◽  
New System

A new system was deviced that allows the electrolytical detachment of platinum microcoils at variable lengths for the endovascular treatment of intracranial aneurysms. The detachment element consists of two short platinum coil segments, which are connected by a threat of stainless steel. The steel threat is interrupted by electrolysis, using a continuous current with 1–2 mA at a voltage of 4–8 Volt. The average detachment time in heparinized blood is about 30–40 sec. The detachment elements can be used to connect either an insertion wire with a platinum coil or to connect several segments of platinum coils with variable helices and lengths. If several detachment elements are integrated in a coil, electrolysis interrupts only the element, which is next beyond the distal tip of the catheter. The electrolytical process does not affect the detachment elements proximal and distal to the element adjacent to the tip of the catheter. Single or several coil segments can be pulled back into the microcatheter if necessary. The system is expected to allow a faster and more complete endovascular coil occlusion of intracranial aneurysms. The principles described in this paper are claimed by the German pending patent DE 100 10840 A1.

scholarly journals Angiographic Results in Intracranial Aneurysms Treated with Inert Platinum Coils

2012 ◽  
Vol 18 (4) ◽  
pp. 391-400 ◽  
Author(s):  
J.R. Vanzin ◽  
C. Mounayer ◽  
D. G. Abud ◽  
R. D'Agostini Annes ◽  
J. Moret
Keyword(s):  
Risk Factors ◽  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Exact Probability ◽  
Aneurysm Neck ◽  
Coil Occlusion ◽  
Risk Factors For Recurrence ◽  
Platinum Coils

This study was designed in an attempt to identify the risk factors that could be significantly associated with angiographic recurrences after selective endovascular treatment of aneurysms with inert platinum coils. A retrospective analysis of all patients with selective endovascular coil occlusion of intracranial aneurysms was prospectively collected from 1999 to 2003. There were 455 aneurysms treated with inert platinum coils and followed by digital subtraction angiography. Angiographic results were classified according Roy and Raymond's classification. Recurrences were subjectively divided into minor and major. The most significant predictors for angiographic recurrences were determined by ANOVAs logistic regression, Cochran-Mantel-Haenszel test, Fisher exact probability. Short-term (4.3±1.4 months) follow-up angiograms were available in 377 aneurysms, middle-term (14.1±4.0 months) in 327 and long-term (37.4±11.5 months) in 180. Recurrences were found in 26.8% of treated aneurysms with a mean of 21±15.7 months of follow-up. Major recurrences needing retreatment were present in 8.8% during a mean period follow-up of 17.9±12.29 months after the initial endovascular treatment. One patient (0.2%) experienced a bleed during the follow-up period. Recurrences after endovascular treatment of aneurysms with inert platinum coils are frequent, but hemorrhages are unusual. Single aneurysm, ruptured aneurysm, neck greater than 4 mm and time of follow-up were risk factors for recurrence after endovascular treatment. The retreatment of recurrent aneurysm decreases the risk of major recurrences 9.8 times. Long-term angiogram monitoring is necessary for the population with significant recurrence predictors.

Endovascular Treatment of Small Intracranial Aneurysms: Three Alternatives to Coil Occlusion

2006 ◽  
Vol 49 (2) ◽  
pp. 65-69 ◽  
Author(s):  
H. Henkes ◽  
J. Reinartz ◽  
H. Preiss ◽  
E. Miloslavski ◽  
M. Kirsch ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Coil Occlusion

scholarly journals In vitro and in vivo Studies of the Extent of Electrothrombotic Deposition of Blood Elements on the Surface of Electrolytically Detachable Coils

2004 ◽  
Vol 10 (3) ◽  
pp. 189-201 ◽  
Author(s):  
H. Henkes ◽  
S. Brew ◽  
S. Felber ◽  
E. Miloslavski ◽  
G. Mogilevski ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intravenous Administration ◽  
Direct Current ◽  
Intracranial Aneurysms ◽  
Thrombus Formation ◽  
Applied Current ◽  
Detachable Coils ◽  
Platinum Coils

Endovascular treatment of intracranial aneurysms with electrolytically detachable coils is often claimed to be based on electrothrombosis, i.e. intra-aneurysmal thrombus formation through applied direct current. Despite the fact that this concept was described more than a century ago, the significance of electrothrombosis in the endovascular treatment of aneurysms remains debatable. Apart from electrothrombosis, mechanical obliteration of the aneurysmal lumen might be one of the many possible mechanisms to explain why and how detachable coils are effective in preventing aneurysms from (re-)rupture. The purpose of this experimental study was to investigate to what extent direct current comparable to that used for coil detachment would influence the adhesion of cellular and liquid blood components to the surface of electrolytically detachable platinum coils. For the in vitro study, electrolytically detachable platinum coils of various types were exposed to stagnant heparinised blood for a total of 16 h, without or with applied direct current for 30 or 90 s (1 mA, 4–6 V, coil as anode). For the in vivo study, electrolytically detachable platinum coils were exposed to flowing blood for 180 s, without or with applied direct current (2 mA, 4–6 V, coil as either anode or cathode), without anti-coagulation and after intravenous administration of 5000 U Heparin and again after the intravenous administration of 500 mg Aspisol in addition to Heparin. After exposure to blood according to these different experimental protocols, the coils were fixed in formalin solution, gold coated and examined by scanning electron microscopy. Thrombus formation on the surface of all unfibred coils was thin and highly variable both from coil to coil, and on different areas of any given coil. The application of direct current minimally enhanced thrombus formation in stagnant blood in vitro, but not in vivo. The cellular and fibrin adhesions on the coil surfaces without and with applied current did not effectively increase the diameter or volume of unfibred coils. Coils with attached nylon fibres, however, proved to be highly thrombogenic without or with application of current. In fibred coils, surface adhesions without and with applied current were voluminous enough to effectively increase the diameter of the coil, potentially important for the process of endosaccular aneurysm occlusion. Electrothrombosis plays no role in the endovascular treatment of intracranial aneurysms with electrolytically detachable coils. This explains why platinum coils with non-electrolytic detachment mechanisms show a similar efficiency and recurrence rate.

Single-center Comparison of Bioactive versus Bare Platinum Coils for the Endovascular Treatment of Intracranial Aneurysms

Neurosurgery ◽  
2008 ◽  
Vol 62 (6) ◽  
pp. 1405
Author(s):  
Michelle J. Smith ◽  
Kyle Chapple ◽  
Justin Mascitelli ◽  
Philip E. Stieg ◽  
Howard A. Riina ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Single Center ◽  
Bare Platinum Coils ◽  
Platinum Coils

Transarterial platinum coil occlusion of ruptured intracranial aneurysms: results in 51 patients

1998 ◽  
Vol 5 (3) ◽  
pp. 283-293 ◽  
Author(s):  
H.T ApSimon ◽  
M.S Khangure ◽  
N Knuckey ◽  
W McAuliffe ◽  
F.J Ives
Keyword(s):  
Intracranial Aneurysms ◽  
Coil Occlusion ◽  
Platinum Coil ◽  
Ruptured Intracranial Aneurysms

Abstract W P75: New Generation Hydrogel Endovascular Aneurysm Treatment Trial

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Samer G Zammar ◽  
Youssef J Hamade ◽  
Jennifer Ward ◽  
Byron K Yip ◽  
Nicole Reinholdt ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Packing Density ◽  
Intracranial Aneurysms ◽  
Recurrence Rates ◽  
2Nd Generation ◽  
Aneurysm Treatment ◽  
Unruptured Intracranial Aneurysms ◽  
Bare Platinum Coils ◽  
New Generation ◽  
Platinum Coils

Background: Endovascular treatment of intracranial aneurysms has seen significant advances. One major limitation of the endovascular approach is durability of treatment and aneurysm recanalization. To address this issue, one approach was the development of hydrogel-coated coils. Hydrogel expands upon exposure to blood and thus enhances coil packing density. Higher initial coil packing density may potentially result in lower rates of recurrence. Hypothesis: The 2nd Generation HydroCoil Embolic System allows for a higher packing density, higher initial occlusion, lower recanalization, and lower retreatment rates compared to bare platinum coils. Objective: To compare clinical and angiographic outcomes (initial complete occlusion, recanalization, retreatment, and adverse event rates) in patients receiving the 2nd Generation HydroCoil Embolic System versus patients receiving bare platinum coils. Methods: This is a randomized, controlled, multicenter, post-market clinical trial. Subjects between 18 and 75 years of age with ruptured or unruptured intracranial aneurysms (3-14 mm in size) who are amenable to endovascular treatment are randomly assigned 1:1 to one of two treatment arms: 1) the HydroCoil Embolic System (HES), or 2) bare platinum coils. No bioactive coils, 1st generation HydroCoils or liquid embolics are allowed in the study. In the HES arm, up to 10% of total coil length using bare platinum is allowed if deemed necessary by the investigator. Any type of bare platinum coil may be utilized in the bare platinum arm. Assist-devices can be used at the discretion of the investigator. The duration of the open enrollment phase will be 24 months or until the required number of subjects are enrolled (n = 600). Each subject will have a post-procedure follow-up of at least 18 months. Subjects will be recruited from up to 50 national and international centers. Each Investigational Site will be expected to enroll at least 20 Subjects. Results: A total of 368 patients have been enrolled to date in the study. The study is still ongoing. Conclusions: A limitation of endovascular aneurysm treatment is recurrence. This trial aims to answer the question of whether the new generation hydrogel coil reduces recurrence rates when compared to bare platinum coils.

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