Stereotactic direct-coiling of aneurysms—a feasibility study

Abstract

Abstract Aim of the study Endovascular coiling has gained worldwide acceptance in the management of intracranial aneurysms. However, not all aneurysms can be coiled. Direct aneurysm puncture with aneurysm thrombosis has been performed, using coils for extracranial aneurysms and iron filings for intracranial aneurysms. Therefore, the feasibility of stereotactic aneurysm coiling with direct aneurysm puncture using Nester-coils was studied in an in vitro model. Methods and findings Twenty-eight aneurysms measuring 9–21 mm in diameters (median 14 mm) were made using 0.1 mm vinyl film that was connected to a monometer with 73 cm of water column. Twenty-three aneurysms were coiled through direct puncture of the aneurysms using a stereotactic frame. Five were coiled using a hand-held probe carrier. Statistical analysis of the data was conducted by data analysis feature of Microsoft Excel. Findings The study showed that needle puncture of the aneurysm and coiling of the aneurysm through the needle can be done with ease and without any significant fluid leak from the puncture site. It also shows that the coil will stay within the aneurysm without entering the neck. The study also shows that this method can be done using free-hand technique. Furthermore, it shows that the probe holder for the needle can also be used as an aneurysm stabilizer and as a tamponade.

Keywords

• Direct-coiling
• Stereotactic surgery
• Cerebral aneurysms
• Subarachnoid hemorrhage
• Neurosurgery