Abstract
Introduction Coil embolization is crucial for managing various neurovascular pathologies. Traditional coils can be limited in high‐flow or complex cases, leading to suboptimal outcomes. The OptiBLOCK coil system is a next‐generation bare platinum device designed to address these limitations through enhanced anchoring and high packing density. This preliminary study presents the first real‐world experience evaluating its technical performance and safety. Methods This is a single‐center, retrospective analysis of a prospectively maintained, IRB‐approved registry of patients who underwent endovascular embolization using OptiBLOCK coils between January 2024 and May 2025. Baseline characteristics, procedural indications, and both clinical and radiologic outcomes were analyzed. Primary endpoints included aneurysm occlusion, complete obliteration of AVMs and AVFs on follow‐up imaging, and target vessel occlusion for tumor devascularization or epistaxis control. Periprocedural and operative device‐related complications were recorded. Results A total of 34 patients were included with diverse neurovascular indications, including head and neck tumor embolization (34.3%), dAVF obliteration (20.0%), aneurysm coiling (14.3%), AVM embolization (14.3%), and epistaxis control (5.7%). All aneurysm coiling procedures achieved complete obliteration (Raymond‐Roy Class I). Epistaxis was successfully controlled through complete embolization of external carotid artery branches. Total obliteration without residual fistula was achieved in all dAVF cases. Preoperative embolization facilitated successful surgical resection in all AVM cases. No device‐related complications, such as coil migration or coil kick‐out, were observed. OptiBLOCK coils were successfully deployed in all cases, achieving total occlusion of all target vessels without intraoperative complications. Conclusion The OptiBLOCK coil system demonstrated technical success and procedural safety across a broad range of neurovascular procedures. Its structural design, featuring high packing density and enhanced anchoring, enabled durable occlusions, particularly in high‐flow vascular lesions. These early findings support an expanding role in neurovascular interventions and highlight the need for prospective multicenter studies with long‐term follow‐up to validate clinical performance.