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. 2016 Feb;8(2):168-72.
doi: 10.1136/neurintsurg-2014-011585. Epub 2015 Jan 27.

Periprocedural safety of aneurysm embolization with the Medina Coil System: the early human experience

Aquilla S Turk  1 , Orlando Maia  2 , Christian Candido Ferreira  2 , Diogo Freitas  2 , J Mocco  3 , Ricardo Hanel  4
Affiliations

Periprocedural safety of aneurysm embolization with the Medina Coil System: the early human experience

Aquilla S Turk et al. J Neurointerv Surg. 2016 Feb.

Abstract

Introduction: Intracranial saccular aneurysms, if untreated, carry a high risk of morbidity and mortality from intracranial bleeding. Embolization coils are the most common treatment. We describe the periprocedural safety and performance of the initial human experience with the next generation Medina Coil System.

Methods: The Medina Coil System is a layered three-dimensional coil made from a radiopaque, shape set core wire, and shape memory alloy outer coil filaments. Nine aneurysms in five patients were selected for treatment with the Medina Coil System.

Results: Nine aneurysms in five patients, ranging from 5 to 17 mm in size in various locations, were treated with the Medina Coil System. No procedural or periprocedural complications were encountered. Procedure times, number of coils used to treat the aneurysm, and use of adjunctive devices were much less than anticipated if conventional coil technology had been used.

Conclusions: The Medina Coil System is a next generation coil that combines all of the familiar and expected procedural safety and technique concepts associated with conventional coils. We found improved circumferential aneurysm filling, which may lead to improved long term outcomes, with fewer devices and faster operating times.

Keywords: Aneurysm; Coil.

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Figures

Figure 1
Figure 1
Medina embolization coil in unconstrained space.
Figure 2
Figure 2
(A) Working frontal digital subtraction angiography (DSA) of a 5 mm left carotid terminus aneurysm. (B, left) Native magnified working view of the coil mass filling the aneurysm and (right) the same projection DSA of the aneurysm occluded with a very small neck residual. (C) One month follow-up DSA magnified working view with stable aneurysm occlusion and a very small neck remnant.
Figure 3
Figure 3
(A, B) A patient who experienced a subarachnoid hemorrhage, 1 month previously, from a 17 mm×9 mm with 5.5 mm neck left anterior communicating region aneurysm, as shown by three-dimensional digital subtraction angiography (DSA) and frontal working view. (C) Final subtracted frontal (left) and native lateral (right) DSA control angiogram showing coils filling the aneurysm, with some contrast penetrating the proximal coil mass and patency of the parent anterior cerebral artery and anterior communicating arteries and their distal branches.
Figure 4
Figure 4
Sequential filling of the aneurysm sac. (A) Subtracted (left) and native (right) digital subtraction angiography (DSA) working view shows an 8 mm framing coil was used to secure the dome of the aneurysm. (B) Subtracted (left) and native (right) DSA working view shows a second 7 mm framing coil was complexed with the first coil and used to create a proximal basket covering the aneurysm ostium. (C) Subtracted (left) and native (right) DSA working view shows the remaining unfilled coil volume within the framing basket was subsequently filled with a 6 mm and then two 5 mm filling coils.
See this image and copyright information in PMC

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