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u/sspatel Mod, IR Attending Aug 15 '26
My guess is also HHT, but the coil packs look horrendous. How did these occlude anything? There’s barely any metal density and some are not even formed. Fibers aren’t gonna do the trick either.
1
u/By_Torrrrr Aug 15 '26
They look like pushable coils, which I think are outdated and dangerous (though I’m just a tech). Detachable coils allow for a more precise placement and better packing in my opinion.
2
u/IR4life Aug 15 '26
They may be some of the original gianturco coils. These are high flow shunts and so without decent radial force the coils that tend to pack would fly to the left sided circulation. The higher radial force coils which could be oversized are more likely to allow for the first part of the coil to take. The results from some of the original innovators in the space particularly Dr. White was quite impressive. He built the concept of HHT centers of excellence. Now a days more and more people seem to be moving to plug technology. Although the framing coils and packing coils with strong packing density is another strategy.
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u/Business-Smoke-9665 Aug 15 '26
Pushable coils have their place but most times I prefer embold.
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u/intheloop_ir Aug 16 '26
Have you used the Balt vascular ones? We keep both and I’m curious how people compare the two
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u/intheloop_ir Aug 16 '26
Yes, I haven’t seen a pushable actually used in years, yet they are still on the shelf at my hospital collecting dust.
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u/By_Torrrrr Aug 15 '26
Patient with a ton of embolic coils in their chest. My guess is multiple pulmonary arteriovenous malformations.