Corey Teigen, MD, is Chairman of Interventional Radiology at Sanford Medical Center in Fargo, North Dakota. He has used Penumbra technology in the brain and elsewhere in the body and worked with Penumbra to optimize their coil technology for vessel occlusion. Penumbra has released a new embolization packing coil designed for use in peripheral vessels and aneurysms in conjunction with the company’s Ruby and POD embolization coils. Vascular Disease Management asked Dr. Teigen to discuss the technology of the new POD Packing Coil.
VDM: Tell us about the development of the POD Packing Coil. What need was it intended to meet?
Teigen: I was using other Penumbra coils for occlusion of vessels but found I needed a stiffer leading portion of the coil followed by a softer coil to pack up against it. The POD Packing Coil is designed for that purpose, to be used behind other Penumbra coils (POD or Ruby) for when we need tighter packing to achieve complete occlusion of a blood vessel.
VDM: What is unique about this coil?
Teigen: There are several unique features of the POD Packing Coil. It fits through a microcatheter, though the coil size is the same as other coils that have to go through a 035˝ catheter. It is detachable, meaning that if I advance the coil and don’t like where it’s positioned, I can re-sheath it and reposition it. This is in contrast to “pushable” coils, which can’t be repositioned. It has high packing density, forming a tight metal pack that completely and permanently occludes the blood vessel. This is significant because previously available coils used technology that causes a clot to form, but the clot can dissolve over time. In fact, one-fourth to one-fifth of clots dissolve, many times requiring additional treatment. Also, it is available in longer lengths – up to 60 centimeters long – so we can use fewer coils. This is both safer and less expensive.
VDM: How does it work or pair with other embolization devices?
Teigen: The POD Packing Coil can be packed in behind other embolization devices to give fast, complete vessel occlusion.
VDM: What conditions/situations will it be most useful for?
Teigen: The POD Packing Coil can be used anywhere in the body we need to occlude a vessel, which may be necessary for a number of reasons.
- Hemorrhage – blocking a vessel to an area that’s bleeding due to trauma or other causes;
- Tumors – preventing blood flow to a tumor to inhibit growth;
- Aneurysms – preventing blood flow to an aneurysm to prevent it from rupturing; and
- Chemotherapy – protecting healthy areas of the body from receiving chemotherapeutic agents.
VDM: How could this improve outcomes for patients?
Teigen: The POD Packing Coil can improve outcomes for patients in 2 ways. First, it enables a faster procedure, resulting in less radiation and lower risk of complications. Second, it creates permanent occlusion of the vessel, reducing need for further procedures.
VDM: Are there any studies under way currently or planned to determine effectiveness?
Teigen: The Aneurysm Coiling Efficiency (ACE) study showed the safe and effective outcome of peripheral embolization with Ruby Coil technology; I was one of the PIs and presented the data at the SIR annual meeting. The POD Packing Coil is a specialized device for vessels that draws on similar Ruby technology and is an addition to the Penumbra’s embolization suite.
VDM: Anything else about this device that vascular clinicians should know?
Teigen: The learning curve for the POD Packing Coil is short. It is based on techniques we use every day with detachable and nondetachable coils. The main thing the vascular clinician needs to learn is how much coil to pack into each vessel. Penumbra provides recommended lengths based on vessel size, and ultimately the vascular clinician’s experience will result in knowledge of how much coil is needed to occlude the vessel.
Editor’s note: Dr. Teigen reports travel expenses provided by Penumbra.