Clinically, packing density is recommended to be 20-30% or more of the aneurysm's volume, typically requiring deployment of multiple wires.

[1] Higher volumes may be difficult due to the delicate nature of the aneurysm; intraoperative rupture rates are as high as 7.6% for this procedure.

[5][6][7] Due to its less invasive nature, endovascular coiling usually presents faster recovery times than surgical clipping, with one study finding a significant decrease in probability of death or dependency compared to a neurosurgical population.

[12] The International Subarachnoid Aneurysm Trial tested the efficacy of endovascular coiling against the traditional micro-surgical clipping.

Similar to patients who experience neurosurgical procedures, coiling results in an increase in resting energy expenditure, albeit at a slightly reduced rate than their neurosurgery counterpart.

[18] Endovascular coiling was a developed through the synthesis of a number of innovations that took place between 1970 and 1990 in the field of electronics, neurosurgery, and interventional radiology.

[19] It did not gain popularity due to the specialized equipment required, in addition to the technique being unsuitable for many types of aneurysms.

[4] Later, in 1980, similar techniques were developed by Alksne and Smith using iron suspended in methyl methacrylate in a limited set of patients.

[4] As a means of avoiding invasive methods, early endovascular interventions involved the usage of detachable and nondetachable balloon catheters to occlude the aneurysm while preserving the parent artery.

This procedure was deemed "uncontrollable" due to its high morbidity and mortality rate, but it demonstrated that the endovascular approach was feasible for many aneurysms.

Techniques such as particle image velocimetry (PIV) and computational fluid dynamics/finite element analysis (CFD/FEA) have yielded results that have influenced the direction of research, but no model to date has been able to account for all factors present.

When combined with CFD/FEA, hemodynamics can be estimated in patient specific simulations, giving the clinician greater predictive tools for surgical planning and outcome evaluation to best promote thrombus formation.

[26][27] However, most computer models use many assumptions for simplicity, including rigid walls (non-elastic) for vasculature, substituting a porous medium in place of physical coil representations, and navier-stokes for fluid behavior.

However, new predictive models are being developed as computational power increases, including algorithms for simulations of coil behavior in-vivo.