Alternative Detachment Technique for Electrically Detachable Coils: Rescue From an Unintended Complication

Abstract

Abstract BACKGROUND Embolization of intracranial aneurysms with the use of detachable coils has become the most widely used therapy for this condition. However, unexpected device failure can lead to critical complications. OBJECTIVE To describe an alternative detachment technique for various electrically detachable coils (eg, Target of Stryker Neurovascular, Presidio and Microphere of Codman Neurovascular, and MicroPlex and Hydrocoil of MicroVention Terumo) that can be used when standard troubleshooting techniques are not effective and the physician is not able to remove a coil. METHODS The alternative detachment method involved the restoration of the current pathway with the use of an alligator clip wire and the distal end of a new coil delivery wire of the same type. The detachment mechanism used in this method is the same as that normally used for each system. RESULTS We found that this alternative maneuver was both feasible and reproducible. Moreover, an electrically detachable coil was successfully detached with the use of this method, especially when detachment failure was the result of distal delivery wire and connector damage. No additional complications were noted. CONCLUSION An alternative detachment technique involving the reconstruction of the electric circuit could be a safe method of rescue in the potentially risky situation caused by detachment failure during embolization of cerebral aneurysms with electrically detachable coils.