Clinical Application of Insertion Force Sensor System for Coil Embolization of Intracranial Aneurysms

Abstract Introduction In endovascular embolization for intracranial aneurysms, it is important to properly control the coil insertion force. However, the force can only be subjectively detected by the subtle feedback experienced by the neurointerventionists at their fingertips. The authors envisioned a system that would objectively sense and quantify that force. In this article, coil insertion force was measured in cases of intracranial aneurysm using this sensor, and its actual clinical application was investigated. Methods The sensor consists of a hemostatic valve (Y-connector). A little flexure was intentionally added in the device and it creates a bend in the delivery wire. The sensor measures the change in the position of the bent wire depending on the insertion force and translates them into a force value. Using this, embolization was performed for 10 unruptured intracranial aneurysms. Results The sensor adequately recorded the force and it reflected the operators’ usual clinical experience. The presence of the sensor did not affect the procedures. The sensor enabled the operators to objectively note and evaluate the insertion force and better cooperative handling was possible. Additionally, other members of the intervention team shared the information. Force records demonstrated the characteristic patterns according to every stage of coiling (framing, filling and finishing). Conclusions The force sensor system adequately measured coil insertion force in intracranial aneurysm coil embolization procedures. The safety of this sensor was demonstrated in clinical application for the limited number of patients. This system is useful adjunct for assisting during coil embolization for an intracranial aneurysm.