Coiling Flashcards
Primary Wire Filament or Filar
The actual wire from which a coil implant is made
Primary Wind
The first wind of the filar made around a mandrel; forming it into a coil or “slinky” shape
Secondary Wind
Second wind of the primary wind which gives the coil its specific shape or configuration
Stretch-Resistant (SR) Element
Present on many coils; located within the primary wind
~connected to distal and proximal ends
~prevents coil from stretching
3 types of coil shapes/configurations
- 3D
- Complex
- Helical (stacks up like coins)
Calculating the percent of packing volume after a coil embolization can be used as an indicator of:
long term success and depends on an accurate calculation of aneurysm volume
Steps to calculate how many coils to put in an aneurysm
1) Calculate volume of the aneurysm ~Height x Width 2)Volume of cylinder/total length of coils deployed ~ (Pi(OD^2)(Length) / 4 ) 3)Calculate percent packing volume ~ (Vol of Coils / Vol of Aneurysm) x 100
What has more impact to coil volume: outer diameter or length of coil?
Outer Diameter
4 REASONS why coil softness is important:
1) conformability
2) durability
3) packability
4) deliverability
4 FACTORS that contribute to coil implant softness:
1) primary wire
2) primary O.D.
3) stretch-resistant element
4) pitch
Stiffness/Softness Measure:
k
If primary wire (Dw) INCREASES; implant is ____
stiffer
~& vice versa
If O.D. INCREASES, implant is _______
softer
~& vice versa
Closed Loop Coils =
STIFFER/more structure
Open-Loop Coils =
SOFTER! no real shape
Axium & Axium Prime indications:
- Endovascular embolization of intracranial aneurysms
-Embolization of other neurovascular abnormalities (AVMs, AVFs)
~Axium Prime (Frame) : arterial and venous embolizations in peripheral vasculature
AXIUM QC Detachable Coil features & benefits
Large loop diameter - sphere diameter ratio & random loop design
benefits:
~enhanced conformability
~deflects into aneurysm space more easily
**CONFORMABLE **UTILITY
Axium QC detachable coil good for:
~irregular shaped aneurysms
~stent-assisted coiling
Axium QC Coil Types:
Hx: 1.5-20
3D: 2-25
Axium QC Secondary Loop Sizes (mm)
- 1.5-3.5
- 4-6
- 7-10
- 12-25
Axium QC Primary Wire Sizes (in)
- .0015
- .0020
- .00225
- .00275
Axium QC Coil Primary O.D (in)
- .0115/11.5
- .0125/12.5
- .0135/13.5
- .0145/14.5
MicroFx microfilaments materials
- PGLA: absorbable suture
- Nylon: permanent; resistance to blood flow
MicroFx ________ Technology
LatticeFX
~overlapping microfilaments
Axium MicroFX Detachable Coil:
Each filament is:
- .0009” in diameter
- 2mm in length
- 2mm in spacing
Axium MicroFx Detachable Coil:
True/False: The first loop is free of microfilaments
True- to maintain first loop performance
Axium MicroFX Coil:
True/False the outer diameter remains the same as the coil gets bigger
False- OD gets bigger as coil gets bigger
MicroFX Coil Types:
*PGLA 3D ~2-18 *PGLA Hx ~2-10 *Nylon Hx ~2-4
MicroFx PGLA 3D Secondary Loop Sizes (mm)
- 2-3
- 4-6
- 7-10
- 12-18
MicroFx PGLA Hx Secondary Loop Sizes (mm)
- 2-3
- 4-6
- 7-10
MicroFx Nylon Hx Secondary Loop Size (mm)
- 2-3
* 4
MicroFx PGLA 3D Primary Wire Size (in)
- .0015
- .0020
- .00225
- .00275
MicroFx PGLA Hx Primary Wire Size (in)
- .0015
- .0020
- .00225
MicroFX Nylon Hx Primary Wire Size (in)
- .0015
* .0020
MicroFx PGLA 3D Primary O.D Size (in)
- .0115/11.5
- .0125/12.5
- .0135/13.5
- .0145/14.5
MicroFx PGLA Hx Primary O.D (in)
- .0115/11.5
- .0125/12.5
- .0135/13.5
MicroFx Nylon Hx Primary O.D. Sizing
- .0115/11.5
* .0125/12.5
3 features of Axium Prime FRAME
2 of 3 now a feature of every coil
1) PRIME FRAME ONLY: hybrid implant design
2) smooth coil delivery
3) reliable detachment
Elements of smooth coil delivery
- Ball & socket design allows for 360 degree axial rotation
- Beveled socket = increased articulation
- tapered pusher = enhanced trackability
~67% increase in angular flexibility
Elements of reliable detachment
- instant MECHANICAL detachment
- 99.7% proven reliability *******
- back-up detachment method: manual option
Prime FC Coil Types
3-25 (3D)
Axium Prime Frame Features
- Open Loop Configuration
- Complete proximal and distal anchor loops
- Uniform loop distribution and dense neck coverage
Axium Prime Soft (different features)
44% thinner .0015” primary wire
38% thinner .0011” stretch-resistant strands
*4x softer implant
Axium Prime SS (Hx & 3D) Secondary Loop Size (mm)
4-6
Axium Prime SS Coil Primary Wire Size (in)
.0015
Axium Prime Soft O.D Size (in)
.0115/11.5
Axium Prime Extra Soft (differentiating characteristics)
-Softness enhanced by thinner .0013” primary wire & larger .0108” primary OD
Coil Abbreviations:
FC=
SS=
ES=
FC= Framing Coil SS= Super Soft Coil ES= Extra Soft
Axium Prime ES Coil Types
- 1-3 (Hx)
* 1-3.5 (3D)
Axium Prime Extra Soft Secondary Loop Size (mm)
1-3.5
Axium Prime Extra Soft Primary Wire Size (in)
.0013”
Axium Prime Extra Soft Primary O.D.(in)
.0108/10.8
Axium Coils: softness Stability
ES –> Soft –> Frame –> MicroFx
4 components of a coil system:
1) Coil Implant
2) Detachment Zone
3) Pusher Wire (Coil alignment marker & exit marker)
4) Detachment Handle
3 coil types:
1) Frame (Basket)
2) Fill (2-4mms)
~dense packing
3) Finishing (2mm)
~soft, small coils–typically placed at neck of aneurysm; super soft and small
A technique where as the coiling progresses, the diameter and length that are chosen get smaller and smaller
~coils typically become softer and softer
Russian Doll Technique
