A report of the clinical use of the Detach-18 mechanical detachable platinum coil in 41 patients

BACKGROUND AND PURPOSE: The purpose of this study was to determine the safe ty and reliability of the mechanical detachment system of a new platinum co il, Detach-18, when used as a vascular occlusive device for neurovascular d isease. METHODS: Forty-one patients (nine male and 32 female patients; age range, 2 6-75 years; mean age, 54.4 years) underwent treatment at seven centers. Twe nty-two patients had dural arteriovenous fistulae of the transverse sinus t reated by a transvenous route. Fourteen patients underwent internal carotid artery occlusion in the treatment of aneurysms, meningioma, facial tumor, or carotid injury. One patient underwent occlusion of the basilar artery an d one patient underwent occlusion of the vertebral artery for treatment of aneurysms. In two patients, coils were used as part of the treatment of the ir arteriovenous malformations. In all cases, the Detach-18 coils were deli vered through a microcatheter with two distal markers, Two types of coils, a 0.015-inch-diameter "regular" coil and a 0.014-inch-diameter "soft" coil, were used, RESULTS: A total of 569 coils were used, 541 of which were detached. The nu mber of coils in ranged from four to 53 (average number of coils, 14), The coils passed easily through the microcatheter. The detachment maneuver occu rred within 10 to 25 s with 20 turns of the introducing wire. No premature coil detachment occurred. Complete occlusion of the vessel lumen was achiev ed in 35 cases. In three cases, 80% to 90% occlusion was achieved. In two c ases, 70% to 80% occlusion was achieved, There were no device-related compl ications. CONCLUSION: The detachment system was safe, reliable, consistent, and fast. This is a useful system for coil embolization in neurovascular application s.