In vitro observation of air bubbles during delivery of various detachable aneurysm embolization coils.
OBJECTIVE
Device- or technique-related air embolism is a drawback of various neuro-endovascular procedures. Detachable aneurysm embolization coils can be sources of such air bubbles. We therefore assessed the formation of air bubbles during in vitro delivery of various detachable coils.


METHODS
A closed circuit simulating a typical endovascular coiling procedure was primed with saline solution degassed by a sonification device. Thirty commercially available detachable coils (7 Axium, 4 GDCs, 5 MicroPlex, 7 Target, and 7 Trufill coils) were tested by using the standard coil flushing and delivery techniques suggested by each manufacturer. The emergence of any air bubbles was monitored with a digital microscope and the images were captured to measure total volumes of air bubbles during coil insertion and detachment and after coil pusher removal.


RESULTS
Air bubbles were seen during insertion or removal of 23 of 30 coils (76.7%), with volumes ranging from 0 to 23.42 mm(3) (median: 0.16 mm(3)). Air bubbles were observed most frequently after removal of the coil pusher. Significantly larger amounts of air bubbles were observed in Target coils.


CONCLUSIONS
Variable volumes of air bubbles are observed while delivering detachable embolization coils, particularly after removal of the coil pusher and especially with Target coils.
Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea. dhlee@amc.seoul.kr
Deok Hee
DH
Lee
Seon Moon
SM
Hwang
Ok Kyun
OK
Lim
Jae Kyun
JK
Kim
D004618:Embolism, Air / Q000209:etiology*; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation*; D066298:In Vitro Techniques; D020766:Intracranial Embolism / Q000209:etiology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008853:Microscopy; D018570:Risk Assessment; D018709:Statistics, Nonparametric