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Interventional Radiology

Coil fiber study shows fibers boost acute occlusion

According to “Nylon fibered versus non-fibered embolization coils: comparison in a swine model,” an animal study authored by interventional radiologist Dr. Scott Trerotola, from the University of Pennsylvania, embolization coils with nylon fibers allow significantly fewer embolization coils to achieve acute occlusion of arteries compared to bare metal coils.

The purpose of this study was to determine whether nylon fibers improve the performance of platinum embolization coils in porcine arteries. The study tested the efficacy of platinum embolization coils, with and without nylon fibers, in the hindlimbs of six juvenile pigs. A total of 24 coils were used—12 with fibers and 12 without fibers. Specifically, the study looked at the number of coils needed to achieve vessel occlusion and the durability of occlusion at 1 and 3 months.

The study found that fewer fibered coils were needed to achieve acute occlusion compared to bare metal coils. A mean of 3.2 bare metal coils was required to achieve occlusion, while a mean of only 1.3 fibered coils was necessary to occlude the targeted vessels. Both fibered and non-fibered coils showed similar rates of recanalization at follow-up.

The study, which was randomized and blinded and utilized a single operator to eliminate experimental bias, is among the first to provide strong evidence supporting what clinicians have long observed: that fibers enhance thrombogenicity. Although some early studies suggested that fibers benefit occlusion, the coil and fiber material used in those studies differs from material in devices used today. The present study compares modern platinum coils both with fibers and without and was designed to limit variables to the greatest extent possible.

The study does provide strong evidence that the incorporation of nylon fibers in metallic embolization coils has been shown to significantly reduce the number of coils required to occlude peripheral arteries. Based on the results of the study, in the setting where acute occlusion is important, it would appear that fibers have an advantage over non-fibered coils.

To read the details of this statistically significant, peer-reviewed in-vivo study published in JVIR, go here.

Dr. Trerotola is a paid consultant of Cook Medical.