Document Detail


MicroNester coils as an adjunct to endovascular embolization.
MedLine Citation:
PMID:  20849798     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES/BACKGROUND: In June 2003, detachable balloons were removed from the US market and were supplanted with coil embolization for parent artery sacrifice in difficult or nonsurgical aneurysms and other vascular pathologies. The current series examines the use of MicroNester pushable coils (Cook Medical, Bloomington, IN) as a low-cost and effective adjunct to detachable coils in the treatment of selected neurovascular pathologies.
METHODS: A retrospective analysis of all patients undergoing neurointerventional procedures from November 2003 through May 2008 was performed to identify patients in whom MicroNester coils were used as part of treatment. Analysis of coil type and number as well as pathology was performed.
RESULTS: MicroNesters were used in 26 cases, of which 21 were for arterial sacrifice--19 for the internal carotid artery and 2 for the vertebral artery. Fourteen were performed for intracranial aneurysms, 3 for pseudoaneurysms, 2 for carotid cavernous fistulae, 1 for a carotid blowout, and 1 for an arteriovenous malformation. Five additional procedures were transvenous, for treatment of dural arterial venous fistulae. The mean number of coils for artery sacrifice was 13, with an average of 10 MicroNesters. For transvenous embolizations, the means were 30 and 6, respectively.
CONCLUSION: MicroNesters are not the coil of choice for most neurointerventional procedures because they are not retrievable. However, when parent artery sacrifice or transvenous occlusion of dural arteriovenous fistulas is the goal, MicroNesters are a relatively inexpensive and equally effective alternative to more expensive, detachable coils and can reduce the procedural costs by $3600 to $6000 for the current series.
Authors:
Wilson P Daugherty; David F Kallmes; Harry J Cloft; Giuseppe L Lanzino
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World neurosurgery     Volume:  73     ISSN:  1878-8750     ISO Abbreviation:  World Neurosurg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-09-20     Completed Date:  2010-10-22     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  390-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA. daugherty.wilson@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Arteriovenous Fistula / pathology,  radiography,  therapy*
Carotid Artery, Internal / pathology,  radiography,  surgery
Child
Cost-Benefit Analysis
Embolization, Therapeutic / economics,  instrumentation*,  methods*
Female
Health Care Costs
Humans
Intracranial Aneurysm / pathology,  radiography,  therapy*
Intracranial Arteriovenous Malformations / pathology,  radiography,  therapy*
Male
Middle Aged
Outcome Assessment (Health Care)
Prostheses and Implants / economics,  standards
Retrospective Studies
Treatment Outcome
Vertebral Artery / pathology,  radiography,  surgery
Young Adult

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