Abstract
Polyglycolic/polylactic acid (PGLA) addition to bare platinum coils is intended to reduce the reopening rate of coiled intracranial aneurysms. Nexus coils are standard complex platinum coils with interwoven PGLA microfilament threads. We present the clinical results of 101 intracranial aneurysms treated with Nexus coils. Results of coiling of 101 aneurysms treated with Nexus coils were compared with our results of coiling of 120 aneurysms with Guglielmi detachable coils (GDC 10) and 115 with Trufill coils treated between May 2003 and December 2004 with the same treatment protocol. Rate of complications, mean aneurysmal volume, packing attenuation, incomplete aneurysmal occlusion at 6 months, and rates of retreatment were compared. Initial occlusion in aneurysms treated with Nexus coils was (near) complete in 97 aneurysms and incomplete in 4 aneurysms. There were no permanent procedural complications (0/95 patients, 0%; 97.5% CI, 0.0% to 3.3%). Mean aneurysmal volume was 180.2 mm(3) (range, 5-1624 mm(3)). Mean packing was 19.4% (range, 7.5% to 38.9%). Six months' angiographic follow-up in 87 of 101 aneurysms showed incomplete occlusion in 14 (16%), and 12 (14%) of those had additional coiling. Mean packing of 19.4% of Nexus coils was significantly lower than 22.9% for GDC 10 and 29.7% for Trufill coils. Other clinical results were not significantly different. In this series, PGLA microfilament Nexus coils were safe to use with clinical results comparable with those of standard platinum coils. This study gives additional evidence of the lack of beneficial effect of PGLA addition to reduce the reopening rate of coiled intracranial aneurysms.
Highlights
AND PURPOSE: Polyglycolic/polylactic acid (PGLA) addition to bare platinum coils is intended to reduce the reopening rate of coiled intracranial aneurysms
In this series, PGLA microfilament Nexus coils were safe to use with clinical results comparable with those of standard platinum coils
Endovascular treatment of intracranial aneurysms with bare platinum coils has become an accepted alternative to surgery.[1]
Summary
Results of coiling of 101 aneurysms treated with Nexus coils were compared with our results of coiling of 120 aneurysms with Guglielmi detachable coils (GDC 10) and 115 with Trufill coils treated between May 2003 and December 2004 with the same treatment protocol. Mean aneurysmal volume, packing attenuation, incomplete aneurysmal occlusion at 6 months, and rates of retreatment were compared. Patients were not consecutive; in the same period, another 23 aneurysms were treated with other types of coils for the following reasons: in the beginning and end of the study period, stock of Nexus coils was incomplete (12 aneurysms), there was operator preference for (thicker) GDC 18 coils (Boston Scientific) in aneurysms of 10 to 20 mm (7 aneurysms), and conversion from Nexus coils to other types of coils took place (4 aneurysms).
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