Original Research Article

Scanning electron microscopy analysis of microcatheter inner lining damage and thrombogenesis in coil embolization:

Coil embolization is a standard treatment for intracranial aneurysms, but ischemic complications remain a concern despite advances in devices and antithrombotic therapy. Microcatheter-related thrombogenesis is considered one cause, yet data on inner lining changes are scarce. The authors examined five SL-10, two Phenom 17, and one Echelon 10 microcatheters used in coil embolization by scanning electron microscopy (SEM), with an unused catheter as control. SEM revealed high-resolution inner surface damage, including peeling and cracking, particularly after multiple coil deliveries, changes not detectable by light microscopy. Red blood cell clots were also observed. Similar alterations appeared in Phenom 17 and Echelon 10. These findings suggest repeated use damages microcatheter linings, potentially contributing to thrombus formation and ischemic events, highlighting the need to improve durability and thromboresistance.

Impression: This study is important because it highlights an underrecognized mechanism of ischemic complications in coil embolization—structural damage to the microcatheter inner lining. By showing detailed morphological changes with SEM, it provides new insight into how devices themselves may promote thrombosis. The findings underscore the importance of evaluating catheter durability, especially with repeated coil deliveries, and encourage innovation toward more thromboresistant microcatheters. Ultimately, this research may lead to safer procedures and improved outcomes for patients with intracranial aneurysms.

From Department of Endovascular Surgery, Institute of Science Tokyo, Bunkyo, Japan

View at: https://doi.org/10.1177/15910199251377132

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