For interventionalists pursuing a durable, lasting vessel takedown during endovascular embolization, the Terumo AZUR HydroPack™ Peripheral Coil System may be the perfect solution.
The AZUR HydroPack™ is a universal-shaped platinum and hydrogel packing coil which utilizes Terumo’s hydrogel formula to find and fill empty space with precise coil placement and a short landing zone. AZUR HydroPack™ has a soft coil design that allows for tight packing and smooth delivery.1
“I always have a lot of faith in the hydrogel technology. In general, I would much rather put a hydrogel coil in over most anything else,” said Robert Grammer, MD, of WVU Medicine.
The hydrogel, a key aspect of Terumo’s AZUR™ peripheral coil products, swells when it interacts with the pH of blood, and can achieve 154% true volume compared to a bare platinum coil.1 The hydrogel polymer doesn’t absorb into the body, but rather acts as a scaffold for regenerative tissue growth.
Zachary L. Bercu, MD, FSIR, of Emory School of Medicine, also said he finds the gel core highly effective in his practice. “Many of our patients may have issues with coagulation,” he said. “The gel core appears to result in more definitive occlusion, especially in these patients, and can facilitate volume filling.”
The AZUR HydroPack™ is the only packing coil on the market that utilizes this hydrogel core technology, and provides a utilitarian option for vessel packing. The coil has a true .018” primary wind and is available in multiple lengths, from 5 to 60 cm, and can be deployed through 2.4Fr or 2.8Fr microcatheters in a single-coil platform. Because of its universal shape, the AZUR HydroPack™ coil allows for flexible sizing.1 Without the need to size the vessel diameter, the AZUR HydroPack™ Coil reduces the amount of inventory required to support a wide variety of vessel/aneurysm sizes.1
According to Dr. Grammer, using the AZUR HydroPack™ has changed his treatment algorithm—rather than using several packing coils to fill a vessel, he now utilizes one or two of the AZUR HydroPack™ coils to fill the same distance.
“The coil behaves almost like a liquid,” said Dr. Grammer. “And it fits in a small vessel that a 2 mm coil would fit in, but also fits a 20 mm vessel. Whether you’re trying to shut down a big or small artery, this coil fits wherever you want to put it.”
Deploying the AZUR HydroPack™ is easy: simply place an anchor coil, such as Terumo AZUR CX™ Peripheral Coil System, and the use the AZUR HydroPack™ to fill the space behind.
“Once I have landed my initial coil, if there is a volume in which I want a dense, tightly packed coil landed with ease and precision, AZUR HydroPack™ is an excellent option,” Dr. Bercu said. “I tend to use fewer coils by using one long AZUR HydroPack™ to fill that space.”
It’s recommended to utilize an open packing technique when deploying the AZUR HydroPack™
“Unlike other coils where you push and pull, with this coil’s open-packing technique you don’t have to fight the coil so much,” said Dr. Grammer. “The AZUR HydroPack™ will almost self-select. You just guide it into position and let it find its path—if it wants to fold over on itself or zigzag, let it go. Let it do what it wants within the confines of where you put it, because when the hydrogel swells, you’re going to have a tight pack.”
The coil’s softness doesn’t come at the expense of microcatheter support, either. “This coil is so soft, but it’s also very sturdy and has more support than you’d expect,” Dr. Grammer said. “It holds its position, and I’m always able to maneuver it back to where I need it to be.”
The AZUR HydroPack™ also features an enhanced pusher wire, which is about 10 cm longer than most other pusher wires on the market.1 It offers more pushability than previous models, which lends itself well to trans-radial procedures, such as prostate artery intervention, Dr. Bercu said.
Under imaging, the AZUR HydroPack™ coil will almost look like a solid mass once the hydrogel has fully swelled.
“You have to have faith in the hydrogel when looking at the images,” Dr. Grammer said. “You may not have the prettiest picture right as you’re placing the coil, but if you give it a little patience and faith, the hydrogel will swell and then you’ll see the vessel flow slowing down. You’ll end up with much better durability and vessel occlusion.”
The reliability of the hydrogel, combined with the reduced number of coils required per intervention, can result in enhanced efficiency and reduced procedure costs.
“Say I’m doing a GI bleed in a vessel. Typically, I’d put a hydrogel anchor coil in, then, to save costs, I’d place multiple fiber coils in the middle and seal it off with a more durable hydrogel coil as a cap,” said Dr. Grammer, explaining that he viewed it as both a cost and time saving to use pushable coils to fill the dead space between.
“I don’t always feel great about the fiber coils in the middle, because I’ve been burned before,” he said. “I often felt like I was sacrificing durability for the sake of cost.”
But now with the Azur HydroPack™ Dr. Grammer no longer has to rely on multiple coils, or weigh cost-saving options.
“When I use the AZUR HydroPack™ coils, I don't feel like I have to sacrifice durability for cost.”
The Terumo Azur HydroPack™ will be featured in the SIR 2024 New Product Showcase. Be sure to stop by Terumo’s Booth 910 at the Expo to learn more about this and other Terumo solutions.
References:
1. Data on file at MicroVention Inc.
PM-07984
Disclaimer: This article is sponsored by an SIR Corporate Partner and does not necessarily reflect the views or policies of SIR. SIR assumes no liability, legal, financial or otherwise, for the accuracy of information in this article or the manner in which it is used. The statements made in the column are not intended to set a standard of care and should not be treated as medical advice nor as a substitute for independent, professional judgment.
