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Retrieval of Migrated Volume Coils Using Different Clot Retrievers in a Porcine Model

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Abstract

Purpose

During endovascular treatment of intracranial aneurysms using coils, migration is a serious complication that increases neurological morbidity. The aim of this experimental study was to assess the effectiveness and complications of retrieving volume coils with different, currently available clot retrievers in a porcine model.

Methods

Volume coils of three-dimensional (3D) shape and different sizes were placed in the axillary artery of pigs. By means of 4 different clot retrievers (Trevo ProVue; Solitaire FR; 3D-Separator; ERIC) a total of 40 retrieval maneuvers (10 per retriever) were performed by deploying the retrievers within the migrated coils and trying to trap parts of the coils by advancing the microcatheter. Retrieval rates, retrieval duration, retrieval attempts, and complications were assessed.

Results

Overall coil retrieval was successful in 31 of 40 cases (77.5%). Retrieval rates using the Trevo ProVue (9/10), Solitaire FR (8/10), and the 3D-Separator (9/10) were higher than when using the ERIC (5/10). Duration of retrieval and retrieval attempts were significantly higher using the ERIC (p < 0.05). Complications like inadvertent deployment were only observed in one case using the Solitaire FR. Additional entrapment of the coil-retriever complex at the intermediate catheter was seen in 9 cases (22.5%). There was no case of vasospasm, perforation, or dissection.

Conclusions

Retrieval of migrated volume coils using new-generation clot retrievers is a feasible and effective method. Retrieval rates and duration with the Trevo ProVue, Solitaire FR, and 3D-Separator are superior when compared to the ERIC.

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Abbreviations

PC 400:

Penumbra 400 Coil System

ERIC:

Embolus Retriever with Interlinked Cages

IC:

Intermediate Catheter

DSA:

Digital Subtraction Angiography

WEB:

Woven Endobridge Device

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Acknowledgements

We would like to thank the team of the Institute for Clinical & Experimental Surgery, Saarland University, for supporting this study.

Author information

Authors and Affiliations

  1. Department of Neuroradiology, Saarland University, Homburg/Saar, Germany

    Andreas Simgen, Toshiki Tomori, Ruben Mühl-Benninghaus, Umut Yilmaz, Heiko Körner & Wolfgang Reith

  2. Department of Anesthesiology, Saarland University, Homburg/Saar, Germany

    Hagen Bomberg

  3. Institute for Clinical and Experimental Surgery, Saarland University, Homburg/Saar, Germany

    Matthias W. Laschke & Michael D. Menger

Authors
  1. Andreas Simgen
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  2. Toshiki Tomori
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  3. Ruben Mühl-Benninghaus
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Corresponding author

Correspondence to Andreas Simgen.

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Conflict of interest

A. Simgen, T. Tomori, R. Mühl-Bennighaus, H. Bomberg, U. Yilmaz, H. Körner, M.W. Laschke, M.D. Menger and W. Reith declare that they have no competing interests.

Ethical standards

The experiments were approved by the local animal protection committee of the Saarland University and conducted in accordance with the European legislation on the protection of animals (Directive 2010/63/EU) and the NIH guidelines on the care and use of laboratory animals (NIH publication #85-23 Rev. 1985).

Additional information

A. Simgen: Interventions, angiographic evaluation and manuscript writing. T. Tomori: Animal care and manuscript writing. R. Mühl-Benninghaus: Animal care and CT scanning. H. Bomberg: Statistical analysis. U. Yilmaz: Angiographic evaluation. H. Körner: Angiographic evaluation. M.W. Laschke: Animal care and manuscript writing. M.D. Menger: Project development and manuscript writing. W. Reith: Project development, interventions, angiographic evaluation and manuscript writing.

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Simgen, A., Tomori, T., Mühl-Benninghaus, R. et al. Retrieval of Migrated Volume Coils Using Different Clot Retrievers in a Porcine Model. Clin Neuroradiol 28, 593–600 (2018). https://doi.org/10.1007/s00062-017-0600-1

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  • DOI: https://doi.org/10.1007/s00062-017-0600-1

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