RESUMO
AIMS: Endovascular coiling is a common modality for treating intracranial aneurysms; however, recanalization occurs in approximately 1 in 5 cases, with downstream consequences of regrowth and rupture. Aneurysm packing density >24% reduces recanalization risk; packing density can be increased by inserting additional coils or by using coils with larger volumetric filling. Coil volume depends on length and primary wind diameter (PWD). This study evaluated the influence of PWD on packing density and total case costs. MATERIALS AND METHODS: Two hypothetical scenarios and one case study were analyzed. In scenario one, the number of coils required to achieve packing density >24% in a hypothetical aneurysm was determined for 0.012â³ vs. 0.010â³ PWD coils. In scenario two, the total length of 0.010â³ vs. 0.012â³ PWD coils required to achieve a packing density >24% was analyzed relative to aneurysm volume. In the case study, packing densities with one 0.012â³ PWD coil (actual scenario) and one 0.010â³ PWD coil (theoretical scenario) were compared. RESULTS: In scenario one, cost savings would be realized by using four 0.012â³ PWD coils vs. seven 0.010â³ PWD coils to achieve packing density >24%. In scenario two, greater volumetric filling of 0.012â³ vs. 0.010â³ PWD coils was correlated with lower total length of coil required. In the case study, a 0.012â³ PWD coil achieved packing density >24%, whereas an equivalent length 0.010â³ PWD coil would not. LIMITATIONS: Theoretical modeling was used to explore the impact of coil PWD on aneurysm packing density. In clinical practice, packing density depends not only on PWD but on its length, shape, distribution within an aneurysm, and other recanalization risk factors. CONCLUSIONS: Coil PWD influences packing density, the number of coils required to achieve a specific packing density, and total case costs. Using 0.012â³ PWD coils may provide cost and procedural efficiencies.
