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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:1377-1380, September 2004
© 2004 American Society of Neuroradiology

INTERVENTIONAL

Radioactive Coil Embolization of Intracranial Aneurysms: Minimal Inventory to Reach Target Activities in a Virtual Series of 154 patients

Charbel Mounayer^a, Michel Piotin^a, Jacques Moret^a and Jean Raymond^b

^a Department of Interventional Neuroradiology Fondation Ophtalmique Adolphe Rothschild, Paris, France
^b the Department of Radiology, Centre Hospitalier de l’Université de Montréal Notre-Dame Hospital, Montreal, Quebec, Canada

Address reprint requests to Dr Jean Raymond, CHUM Notre-Dame Hospital, Interventional Neuroradiology, 1560 Sherbrooke East, Suite M-8203, Montreal, Quebec, Canada H2L 4M1

BACKGROUND AND PURPOSE: Recanalization after selective endovascular treatment of intracranial aneurysms with platinum coils has been widely reported in the literature. Beta radiation emitted from ³²P ion–implanted coils can prevent recanalization in animal models. A complete inventory of radioactive coils may not be realistic; our hypothesis was that it might not be necessary to reach target activities in most aneurysms. A limited supply of three or four types of coils may decrease the inventory difficulties related to the use of an isotope with a half-life of 2 weeks.

METHODS: We reviewed 154 aneurysms selectively treated with standard coils. We calculated the volumetric activity obtained if all coils (simulation 1) were radioactive with linear activities of 0.13 (scenario I) or 0.26 µCi/cm (scenario II). Then, we simulated a treatment with standard coils plus a selection of radioactive coils limited to three (simulation 2) or four types of commonly used coils (simulation 3). Resulting activities were calculated and reported to the lesion volume. For each scenario and simulation, the percentage of lesions, in which the target volumetric activity (0.018 µCi/mm ³) was reached, was reported.

RESULTS: Success in reaching target volumetric activities varied from 55–99% according to different simulations. A supply of four types of coils was sufficient to reach target activities in 86–95% of patients commonly treated in our institution. Target activities were difficult to reach in giant aneurysms.

CONCLUSION: It is feasible to reach target activities in most lesions by using a limited coil supply.

This article has been cited by other articles:

				J. Raymond, C. Mounayer, I. Salazkin, A. Metcalfe, G. Gevry, C. Janicki, S. Roorda, and P. Leblanc Safety and Effectiveness of Radioactive Coil Embolization of Aneurysms: Effects of Radiation on Recanalization, Clot Organization, Neointima Formation, and Surrounding Nerves in Experimental Models Stroke, August 1, 2006; 37(8): 2147 - 2152. [Abstract] [Full Text] [PDF]

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