Single-Center Experience with the Optiblock Coil: An Efficient and Thrombogenic Solution for Targeted Vessel Takedown

Background: Coil technology has traditionally centered around aneurysm occlusion. Optiblock coils are a volumetric system engineered for targeted vessel takedown, featuring extended lengths and an integrated anchor–basket–fill design to enhance packing efficiency and thrombogenicity. The aim of this study is to evaluate the safety, efficiency, and versatility of Optiblock coils in nonaneurysmal neurointerventional procedures. Methods: This single-center, retrospective study included 95 patients who underwent embolization between March 2023 and December 2024 with ≥1 Optiblock coil(s). Indications comprised dural arteriovenous fistulas, preoperative internal maxillary artery embolization for temporomandibular joint surgery, venous diverticulum/emissary vein embolization for pulsatile tinnitus, parent vessel sacrifice, middle meningeal artery embolization for chronic subdural hematoma, and tumor feeder embolization. Procedural characteristics and safety outcomes were analyzed. Results: The mean age was 56 ± 16 years; 53% were female. Transarterial approaches accounted for 62% of cases. Procedures used a median of 5 (interquartile range 2–8) coils with a mean total Optiblock length of 56 ± 127 cm. Adjunct coils were used in 34% and liquid or particle embolics in 28% of procedures. Coil utilization varied by indication, with the highest use in dural arteriovenous fistulas and temporomandibular joint embolizations and the lowest in middle meningeal artery embolization and vessel sacrifice. No intraoperative or delayed complications occurred. Four deaths (4.2%) were observed during follow-up, none of which were related to the embolization procedure. Conclusions: Optiblock coils demonstrated a favorable safety profile and technical versatility for vessel occlusion across diverse indications in this initial clinical series.