Guglielmi Detachable Coil Extraction: Suction Generated by Pusher-Wire Withdrawal after Coil Detachment within an Intracranial Aneurysm
Perry P. Nga,
Van V. Halbacha,
Louis P. Caraginea,
Christopher F. Dowda and
Randall T. Higashidaa
a From the Division of Interventional Neuroradiology, University of California at San Francisco Medical Center, San Francisco, CA
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FIG 1. A, Unsubtracted right anterior-oblique projection before detachment of the first coil. The microcatheter tip is displaced outside the coil mass, but the entire coil has been delivered into the aneurysm (black arrow). The pusher-wire marker overlays the proximal marker of the microcatheter (arrowhead). Note balloon catheter in situ for balloon-remodeling technique (white arrow).
B, Unsubtracted projection after coil detachment and withdrawal of pusher-wire shows 1–2 cm of coil retraction into the microcatheter (arrows)
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FIG 2. Experimental simulation components.
A, Bowl containing normal saline.
B, Microcatheter containing coil.
C, Power supply.
D, Grounding electrode.
E, Positive electrode attached to pusher wire.
F, Perfusion sidearm.
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FIG 3. Digital radiographs of experimental simulation achieved by using Excel-14 microcatheter with GDC-10 2D, 8 mm x 30 cm
A, After coil detachment, before removal of pusher-wire. Note position of coil end (black arrow) and pusher-wire marker (white arrow) near proximal marker of microcatheter (arrowhead).
B, After brisk withdrawal of pusher wire. Note substantial coil retraction into microcatheter (white arrows)
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FIG 4. Digital radiographs of experimental simulation by using Prowler-Plus microcatheter with GDC-10 ultrasoft, 4 mm x 6 cm.
A, After coil detachment, before removal of pusher-wire. Note position of coil end (black arrow) within microcatheter tip.
B, After brisk withdrawal of pusher wire. Note minimal coil retraction into microcatheter (white arrow).
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