• Noriaki Matsubara, Shigeru Miyachi, Takashi Izumi, Hiroyuki Yamada, Naoki Marui, Keisuke Ota, Hayato Tajima, Kazunori Shintai, Masashi Ito, Tasuku Imai, Masahiro Nishihori, and Toshihiko Wakabayashi.
• Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; Department of Neurosurgery and Neuroendovascular Therapy, Osaka Medical College, Takatsuki, Osaka, Japan. Electronic address: mnoriaki0817@yahoo.co.jp.
• World Neurosurg. 2017 Sep 1; 105: 857-863.

IntroductionIn 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 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.MethodsThe 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 it into a force value. Using this, embolization was performed for 10 unruptured intracranial aneurysms.ResultsThe 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).ConclusionsThe 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.Copyright © 2017 Elsevier Inc. All rights reserved.

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