THE EFFECT OF FLOW ARREST ON DISTAL EMBOLIC EVENTS DURING ARTERIAL-OCCLUSION WITH DETACHABLE COILS - A CANINE STUDY

PURPOSE: To determine the effect of proximal flow arrest on the freque ncy and timing of distal embolic events during occlusion of the common femoral artery with detachable coils. METHODS: Twenty-three complex f ibered platinum coils were delivered into 10 common femoral arteries w ithout proximal flow arrest. The arteries were continuously monitored for flow and embolic events by Doppler sonography during delivery and for at least 10 minutes after delivery of each coil. Thirty-four coils were delivered into 6 arteries after proximal flow arrest by inflatio n of a nondetachable balloon. After balloon deflation, each artery was monitored by Doppler sonography for 10 minutes. RESULTS: In the 10 ar teries occluded without flow arrest, 87 events (8.7 per artery) occurr ed, of which 47 were embolic and 40 were indeterminate. In the 6 arter ies with flow arrest, the number of emboli detected was 3 (0.5 per art ery). Embolic events occurred only if there was residual flow. In thos e arteries that were occluded when the flow-arrest balloon was deflate d, no emboli were detected. CONCLUSIONS: Proximal flow arrest virtuall y eliminates the risk of distal emboli during arterial occlusion with detachable fibered coils. The use of fibered coils, in conjunction wit h proximal flow arrest, allows for safe arterial occlusion when detach able balloons are not available or their use is not feasible.