703 Endosaccular Treatment of Intracranial Aneurysms Using a New Hydrogel-coated Self-expandable Coil (HydroCoil): Early Experience from a Single Large-volume Center

Abstract

INTRODUCTION: HydroCoils are a new generation of enhanced coils developed for endovascular occlusion of intracranial aneurysms. These self-expanding coils are intended to result in increased volumetric filling, thereby reducing coil compaction and aneurysm recanalization. We review our initial experience with the technical aspects of this coil, as well as early clinical and angiographic results. METHODS: Data were prospectively collected on 51 intracranial saccular aneurysms (of a total of 126 aneurysms treated during this period) in 50 patients treated between November 2002 and November 2003 in which at least one HydroCoil was used. Information collected included patient age and presentation, aneurysm location and size, initial occlusion status, clinical status at discharge, number and percentage of HydroCoils used and initial and follow-up angiographic results, when available. RESULTS: Thirty patients (59%) presented with subarachnoid hemorrhage (SAH). Thirty-seven (73%) aneurysms were in the anterior circulation, and the average aneurysm diameter was 9.3 mm. There were no technical difficulties with coil preparation or deployment. Forty-two aneuryms (82%) had initial angiographic occlusion of >90%, with HydroCoils constituting an average of 68% of total coil volume. There was angiographic follow-up in 23 aneurysms (45%) showing stable occlusion in 18 (78%) and coil compaction in 5 (22%) at a mean follow-up of 6.7 months; 2 of these were recoiled, and 1 was referred for surgical clipping. Glasgow Outcome Scale score on discharge and percentage discharged to home were similar to those for patients treated with other coils. There were four complications (8%) related to treatment, none with clinical sequelae. There were two rehemorrhages. CONCLUSION: This represents the largest series of intracranial aneurysms treated with HydroCoils. We found the coils easy to use and to have similar early angiographic and clinical results, including complication and compaction rates, compared with GDC coils. Further long-term studies are needed to assess the ability of HydroCoils to decrease recanalization rates.