Neurovascular Coils: A Vascular Disease Doctor's Weapon

Principle of Neurovascular Coils

Neurovascular coils are typically made of platinum, offering excellent flexibility and shape memory properties. They are connected to a stainless-steel guide wire and can be delivered into an aneurysm cavity via a microcatheter. Within the aneurysm, the neurovascular coil gradually forms a thrombus, which can seal off the aneurysm and prevent blood flow from entering, thus reducing the risk of aneurysm rupture. Specifically, when direct current is passed through the catheter, the coil attracts negatively charged blood components (such as red blood cells, white blood cells, and platelets), which undergo electrocoagulation reactions, promoting thrombus formation. Additionally, the part of the coil connected to the stainless-steel wire undergoes electrolytic dissolution, releasing the coil to stay within the aneurysm.

Application of Neurovascular Coils in the Treatment of Cerebral Aneurysms

Neurovascular coils are especially suitable for saccular aneurysms that are reachable by catheterization. They show unique advantages in patients with severe conditions or when surgery is difficult, particularly for early-stage ruptured aneurysms. International research indicates that about 90% of intracranial aneurysms can be treated using embolization. The application of neurovascular coils has become increasingly common and has been widely adopted in many hospitals.

Key Steps in Neurovascular Coil Embolization

Microcatheter Positioning: The microcatheter must be accurately positioned and fixed within the aneurysm cavity. This process requires the microcatheter to avoid excessive twisting with adequate support from the guiding catheter. To prevent excessive twisting of the microcatheter, the guiding catheter is usually inserted to the base of the skull, and the shape of the microcatheter is adjusted based on the angle between the aneurysm and the parent artery, as well as the distance from the center of the aneurysm cavity to the side wall of the parent artery.

Selecting the Appropriate Coil: Choosing the correct model and size of neurovascular coil is crucial during the embolization process. Commonly used neurovascular coil models include GDC-10 and GDC-18, each available in single-diameter, double-diameter (2D), and three-dimensional (3D) types. The single-diameter and double-diameter types are further categorized into standard and soft types. Choosing the appropriate coil model based on the aneurysm’s shape and size is essential to ensure effective treatment.

Advantages of Neurovascular Coils

• Excellent Flexibility: Neurovascular coils are highly flexible, demonstrating good compliance as they navigate within the aneurysm, easily adapting to its shape.

  
  

• Adjustability: If the initial placement is not ideal, the coil can be readjusted to ensure precise treatment.

  
  

• Reduced Risk of Arterial Occlusion: Compared to traditional methods, neurovascular coil embolization has a lower risk of parent artery occlusion and is relatively easy to perform.

Neurovascular coil embolization plays a crucial role in the treatment of cerebral aneurysms. With continuous technological advancements, new coil models and application methods have emerged, making this treatment modality increasingly sophisticated and widespread. Whether dealing with simple saccular aneurysms or complex ruptured aneurysms, neurovascular coils have shown effective results, offering patients a relatively safe and effective treatment option.