Abstract
Denser coil packing in intracranial aneurysms is believed to result in lower recanalization rates. Hydrogel-coated expandable coils (HydroCoil) improve volumetric packing of aneurysms in animal models and clinical studies, but data from large clinical series are limited. The objective of this retrospective analysis was to analyze immediate and follow-up angiographic results as well as complications in a large consecutive series of patients treated with HydroCoils at a single institution. Retrospective analysis was performed of periprocedural complications, immediate and follow-up angiograms, and retreatments of the first 200 consecutive intracranial aneurysms treated at Emory University Hospital. One hundred eighty-seven patients with 200 intracranial aneurysms were treated with HydroCoils during a 3-year period. Immediate angiograms showed complete aneurysmal obliteration in 58.4% of small aneurysms and 42.7% of large aneurysms. Periprocedural complications included early rebleeding and thromboembolic events resulting in permanent neurologic morbidity and mortality in 6% of cases. Follow-up angiography during an average of 16.3 months demonstrated recanalization in 17.7% of small aneurysms and 28.6% of large aneurysms, requiring retreatment in 6.3% and 19.0% of cases, respectively. During the same time period, there was delayed angiographic improvement in aneurysm obliteration in 26.6% of small aneurysms and 26.2% of large aneurysms. First-generation HydroCoil treatment of intracranial aneurysms has a favorable rate of recanalization compared with most large series of pure platinum coils with similar complication rates.
Highlights
AND PURPOSE: Denser coil packing in intracranial aneurysms is believed to result in lower recanalization rates
First-generation HydroCoil treatment of intracranial aneurysms has a favorable rate of recanalization compared with most large series of pure platinum coils with similar complication rates
Treatment of intracranial aneurysms with bare platinum coils was shown to improve outcome in patients with ruptured cerebral aneurysms compared with surgical clipping in a large randomized multicenter trial.[1]
Summary
Retrospective analysis was performed of periprocedural complications, immediate and follow-up angiograms, and retreatments of the first 200 consecutive intracranial aneurysms treated at Emory University Hospital. Records of all consecutive patients treated with HydroCoils at Emory Hospital from October 2002 to October 2005 were reviewed, including clinic notes, procedure notes, and discharge summaries along with pertinent neuroimaging. A data base of the first 200 consecutive cases was created, and a retrospective analysis was performed. The HydroCoils were considered to be mechanically stiffer than identically sized bare platinum coils, requiring more space within the aneurysm lumen. All patients were treated under general anesthesia and fully heparinized with 5000 U intravenously administered at the beginning of the procedure, with subsequent 1000-U redosing at 1-hour intervals. The aneurysm was typically framed with a bare platinum fram-
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