Ex vivo study of the physical effect of coils on pressure and flow dynamics in experimental aneurysms

BACKGROUND AND PURPOSE: Recent experimental studies and a few case reports reveal that coiling may not lead to permanent occlusion of aneurysms by an organized thrombus, Therefore, biologic long-term prognosis seems to be dou btful, and the physical effect of coils may be important. The purpose of th is study was to investigate the physical effect of coils on pressure and ho w dynamics in aneurysms. METHODS: Bifurcation aneurysms were created in eight rabbits, explanted aft er 3 weeks, and tested in a model with pulsatile perfusion with 0.9% saline and heparinized blood. Before and after densely packing with coils, system ic and intraaneurysmal pressure, aneurysmal pulsation, and impact measureme nts were recorded. RESULTS: The peak and shape of the pressure waves in the aneurysm and in th e delivery system were not significantly different before and after coiling . Under physiological intraaneurysmal pressure (while being perfused with s aline), significant reduction (P = .022) of aneurysmal wall pulsation after coil embolization was noted. Overall, the aneurysmal impact on surrounding structures was statistically unchanged after coiling, However, in a few ca ses, after coil embolization, the observed increase of impact was more than doubled compared with the original values before coiling. CONCLUSION: Coils do not physically affect intraaneurysmal pressure. After coiling, there is no significant reduction of how rates through the aneurys m and no reduction of aneurysmal impact, but aneurysmal wall pulsation may be decreased.