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https://doi.org/10.21203/rs.3....
Article . 2025 . Peer-reviewed
License: CC BY
Data sources: Crossref
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PubMed Central
Article . 2025
License: CC BY
Data sources: PubMed Central
Cureus
Article . 2025 . Peer-reviewed
Data sources: Crossref
Cureus
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Vessel Curvature and Microcatheter-Detachable Coil Compatibility in Arterial Coil Embolization

Authors: Kenichiro Okumura; Takahiro Ogi; Junichi Matsumoto; Nobuyuki Asato; Fumihito Toshima; Atsushi Takamatsu; Hirohito Osanai; +3 Authors

Vessel Curvature and Microcatheter-Detachable Coil Compatibility in Arterial Coil Embolization

Abstract

Abstract Purpose: This study examined whether sharp vessel angulation (≥90–180°) and microcatheter–detachable coil compatibility independently increase coil maldelivery in non-neuro arterial embolization, and how these factors affect technical failure and salvage strategies. Materials and Methods: A single-center, IRB-approved analysis from February 2023 to December 2024 included 451 arterial branch–detachable coil combinations (BCCs) in 119 patients (mean age 64 years, range 32–87). Angulations of 90–180° at the proximal catheter segment and distal tip were evaluated on digital subtraction angiography. Technical failure was defined as inability to deploy the coil as intended, including unraveling or coil shape distortion. A 1:3 propensity score matching (28 failed vs 61 successful BCCs) balanced coil features and target-vessel factors. Mismatch was recorded if coil primary diameter exceeded or fell below microcatheter thresholds. A generalized linear mixed model accounted for within-patient clustering. Results: Coil failure occurred in 28 of 451 BCCs (6.2 %). A 90–180° inversion at the catheter tip (odds ratio [OR], 22; p = 0.008) and mismatch (OR, 4.9; p = 0.03) independently predicted failure. A proximal 90–180° inversion also contributed (OR, 4.5; p = 0.03). Of 28 failures, 21/28 (75%) were mismatched: 16/21 (76%) resolved via mismatch correction, and 5/21 (24%) required repositioning or an alternate coil gauge/length. Proper-match failures (n=7) were treated with thinner or more flexible coils in 6 (85.7%; p < 0.0001). Conclusions: Sharp vessel angulation (≥90–180°) and microcatheter–coil mismatch each heighten maldelivery risk. Repositioning or adjusting coil dimensions can salvage mismatched cases, whereas more flexible coils help in matched cases.

Keywords

Radiology

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green
hybrid