ENDOVASCULAR OCCLUSION WITH A NEW MECHANICAL DETACHABLE COIL

OBJECTIVE. Metallic coils have been used for vascular embolization for many years but controlled-release coils have only recently become com mercially available. Most of these devices are microcoils that were ma nufactured primarily for the packing of intracerebral aneurysms; there fore, they lack radial force and are not ideal agents for the occlusio n of high-how lesions such as pulmonary arteriovenous malformations (P AVMs). The objective of this study was to review our experience with a new detachable coil based on the conventional Gianturco-Wallace coil. SUBJECTS AND METHODS. The new detachable coil was initially used for the treatment of varicocele in 20 patients. Subsequently, the coil was used in 48 patients during 90 procedures for the treatment of PAVMs. RESULTS. A total of 548 coils were used. Complete occlusion of the tes ticular vein was achieved in all patients with varicocele. Successful occlusion of the PAVM being treated was achieved in all patients, and no instances of recanalization were documented in any of the patients who returned for follow-up angiography. Forty-one coils had to be remo ved completely from the catheter before detachment because of inapprop riate size or position. Eight coils failed to detach easily, and six o f these had to be removed. Most of those device failures were associat ed with kinking of the screw thread mechanism between the coil and the delivery wire. CONCLUSION. The Jackson detachable coil allows safer m ore accurate, and more distal embolization of PAVMs than is possible w ith nondetachable coils. Complications associated with its use have be en few.