Safety and immediate outcomes of the new generation Swift PAC coil in cerebrovascular pathology: A case series.

BackgroundCoils are widely used in neurovascular interventions due to their effectiveness in achieving precise occlusion of blood vessels. Recently introduced SwiftPAC coil (Penumbra, Alameda, CA) is known for its innovative two-dimensional wave-like design, which makes it adaptable to irregular spaces within vessels with complex anatomical structures often encountered in the head and neck.MethodsWe studied 18 consecutive patients treated using the SwiftPAC coil. The patients underwent pre-procedural imaging and then underwent transfemoral angiography and embolization. The primary outcome measure was technical success, defined as complete occlusion of the target vessel, complication rates, and resolution of clinical symptoms. Secondary outcome measures included the number and size of coils used, procedure duration, and length of hospital stay. These metrics were compared across different indications.ResultsOur analysis included 18 patients (10 females and eight males) aged 16-88 years (mean age: 51 years). Indications for treatment included post-traumatic vessel sacrifices, preoperative embolization for tumors, severe epistaxis, temporo-mandibular joint dysfunction, acute and chronic subdural hematomas, direct carotid-cavernous fistula, aneurysm recurrence, and oropharyngeal hemorrhage. An average of 7 coils was deployed per patient (range: 1-22 coils). All procedures were technically successful except for one case, which was complicated by significant vasospasm preventing coil deployment. Six patients underwent elective embolization, while the remainder underwent urgent and emergent interventions. No major complications were observed.ConclusionsThe SwiftPAC coil is a safe, effective, and efficient two-dimensional wave coil system delivered through a 0.0165″ microcatheter for a variety of indications ranging from middle meningeal artery to vessel sacrifice.