Coiling

Question 1

Primary Wire Filament or Filar

Answer 1

The actual wire from which a coil implant is made

Question 2

Primary Wind

Answer 2

The first wind of the filar made around a mandrel; forming it into a coil or “slinky” shape

Question 3

Secondary Wind

Answer 3

Second wind of the primary wind which gives the coil its specific shape or configuration

Question 4

Stretch-Resistant (SR) Element

Answer 4

Present on many coils; located within the primary wind
~connected to distal and proximal ends
~prevents coil from stretching

Question 5

3 types of coil shapes/configurations

Answer 5

• 3D
• Complex
• Helical (stacks up like coins)

Question 6

Calculating the percent of packing volume after a coil embolization can be used as an indicator of:

Answer 6

long term success and depends on an accurate calculation of aneurysm volume

Question 7

Steps to calculate how many coils to put in an aneurysm

Answer 7

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

Question 8

What has more impact to coil volume: outer diameter or length of coil?

Answer 8

Outer Diameter

Question 9

4 REASONS why coil softness is important:

Answer 9

1) conformability
2) durability
3) packability
4) deliverability

Question 10

4 FACTORS that contribute to coil implant softness:

Answer 10

1) primary wire
2) primary O.D.
3) stretch-resistant element
4) pitch

Question 11

Stiffness/Softness Measure:

Answer 11

k

Question 12

If primary wire (Dw) INCREASES; implant is ____

Answer 12

stiffer

~& vice versa

Question 13

If O.D. INCREASES, implant is _______

Answer 13

softer

~& vice versa

Question 14

Closed Loop Coils =

Answer 14

STIFFER/more structure

Question 15

Open-Loop Coils =

Answer 15

SOFTER! no real shape

Question 16

Axium & Axium Prime indications:

Answer 16

• Endovascular embolization of intracranial aneurysms
  -Embolization of other neurovascular abnormalities (AVMs, AVFs)
  ~Axium Prime (Frame) : arterial and venous embolizations in peripheral vasculature

Question 17

AXIUM QC Detachable Coil features & benefits

Answer 17

Large loop diameter - sphere diameter ratio & random loop design

benefits:
~enhanced conformability
~deflects into aneurysm space more easily

**CONFORMABLE **UTILITY

Question 18

Axium QC detachable coil good for:

Answer 18

~irregular shaped aneurysms

~stent-assisted coiling

Question 19

Axium QC Coil Types:

Answer 19

Hx: 1.5-20
3D: 2-25

Question 20

Axium QC Secondary Loop Sizes (mm)

Answer 20

• 1.5-3.5
• 4-6
• 7-10
• 12-25

Question 21

Axium QC Primary Wire Sizes (in)

Answer 21

• .0015
• .0020
• .00225
• .00275

Question 22

Axium QC Coil Primary O.D (in)

Answer 22

• .0115/11.5
• .0125/12.5
• .0135/13.5
• .0145/14.5

Question 23

MicroFx microfilaments materials

Answer 23

• PGLA: absorbable suture

- Nylon: permanent; resistance to blood flow

Question 24

MicroFx ________ Technology

Answer 24

LatticeFX

~overlapping microfilaments

Question 25

Axium MicroFX Detachable Coil: | Each filament is:

Answer 25

- .0009" in diameter - 2mm in length - 2mm in spacing

Question 26

Axium MicroFx Detachable Coil: | True/False: The first loop is free of microfilaments

Answer 26

True- to maintain first loop performance

Question 27

Axium MicroFX Coil: | True/False the outer diameter remains the same as the coil gets bigger

Answer 27

False- OD gets bigger as coil gets bigger

Question 28

MicroFX Coil Types:

Answer 28

``` *PGLA 3D ~2-18 *PGLA Hx ~2-10 *Nylon Hx ~2-4 ```

Question 29

MicroFx PGLA 3D Secondary Loop Sizes (mm)

Answer 29

* 2-3 * 4-6 * 7-10 * 12-18

Question 30

MicroFx PGLA Hx Secondary Loop Sizes (mm)

Answer 30

* 2-3 * 4-6 * 7-10

Question 31

MicroFx Nylon Hx Secondary Loop Size (mm)

Answer 31

* 2-3 | * 4

Question 32

MicroFx PGLA 3D Primary Wire Size (in)

Answer 32

* .0015 * .0020 * .00225 * .00275

Question 33

MicroFx PGLA Hx Primary Wire Size (in)

Answer 33

* .0015 * .0020 * .00225

Question 34

MicroFX Nylon Hx Primary Wire Size (in)

Answer 34

* .0015 | * .0020

Question 35

MicroFx PGLA 3D Primary O.D Size (in)

Answer 35

* .0115/11.5 * .0125/12.5 * .0135/13.5 * .0145/14.5

Question 36

MicroFx PGLA Hx Primary O.D (in)

Answer 36

* .0115/11.5 * .0125/12.5 * .0135/13.5

Question 37

MicroFx Nylon Hx Primary O.D. Sizing

Answer 37

* .0115/11.5 | * .0125/12.5

Question 38

3 features of Axium Prime FRAME | 2 of 3 now a feature of every coil

Answer 38

1) PRIME FRAME ONLY: hybrid implant design 2) smooth coil delivery 3) reliable detachment

Question 39

Elements of smooth coil delivery

Answer 39

* Ball & socket design allows for 360 degree axial rotation * Beveled socket = increased articulation * tapered pusher = enhanced trackability ~67% increase in angular flexibility

Question 40

Elements of reliable detachment

Answer 40

- instant MECHANICAL detachment - 99.7% proven reliability ********* - back-up detachment method: manual option

Question 41

Prime FC Coil Types

Answer 41

3-25 (3D)

Question 42

Axium Prime Frame Features

Answer 42

- Open Loop Configuration - Complete proximal and distal anchor loops - Uniform loop distribution and dense neck coverage

Question 43

Axium Prime Soft (different features)

Answer 43

44% thinner .0015" primary wire 38% thinner .0011" stretch-resistant strands *4x softer implant

Question 44

Axium Prime SS (Hx & 3D) Secondary Loop Size (mm)

Answer 44

4-6

Question 45

Axium Prime SS Coil Primary Wire Size (in)

Answer 45

.0015

Question 46

Axium Prime Soft O.D Size (in)

Answer 46

.0115/11.5

Question 47

Axium Prime Extra Soft (differentiating characteristics)

Answer 47

-Softness enhanced by thinner .0013" primary wire & larger .0108" primary OD

Question 48

Coil Abbreviations: FC= SS= ES=

Answer 48

``` FC= Framing Coil SS= Super Soft Coil ES= Extra Soft ```

Question 49

Axium Prime ES Coil Types

Answer 49

* 1-3 (Hx) | * 1-3.5 (3D)

Question 50

Axium Prime Extra Soft Secondary Loop Size (mm)

Answer 50

1-3.5

Question 51

Axium Prime Extra Soft Primary Wire Size (in)

Answer 51

.0013"

Question 52

Axium Prime Extra Soft Primary O.D.(in)

Answer 52

.0108/10.8

Question 53

Axium Coils: softness Stability

Answer 53

ES --> Soft --> Frame --> MicroFx

Question 54

4 components of a coil system:

Answer 54

1) Coil Implant 2) Detachment Zone 3) Pusher Wire (Coil alignment marker & exit marker) 4) Detachment Handle

Question 55

3 coil types:

Answer 55

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

Question 56

A technique where as the coiling progresses, the diameter and length that are chosen get smaller and smaller ~coils typically become softer and softer

Answer 56

Russian Doll Technique