Abstract
Endovascular treatment of intracranial aneurysms using platinum coils is effective, but uncommonly aneurysms recur. New-generation coils, such as Cerecyte, aim to address this problem. This study examines the safety and efficacy of these coils in the treatment of a cohort of ruptured and unruptured aneurysms Sixty-seven patients with 68 aneurysms were included in the study. Of these, 51 were treated exclusively with the new polyglycolic acid (PGA)-containing coils, and 17 were treated with a combination of new PGA-containing and other coils. Initial and follow-up angiograms were graded according to the 3-point scale of occlusion. Follow-up angiography was available in 46 cases at 6 months. Based on occlusion grading at initial and follow-up angiography, aneurysms were classified into stable, improved, and worsened (recanalized) groups. Of the exclusive new-coil cohort, 36 cases (70.6%) were initially completely occluded (grade 1), 12 (23.5%) showed filling at the neck (grade 2), and 3 (5.9%) showed contrast within the neck and sac (grade 3). Analysis of the follow-up angiograms showed 24 (70.6%) had stable occlusion, 3 (8.8%) had improved occlusion, and 7 (20.6%) had worsening occlusion. Data for cases treated with new PGA-containing coils together with bare platinum coils were also analyzed separately. Intraprocedural adverse events were noted in 4 cases (7.8%), but there were no clinical sequelae. There were no rebleeds in the follow-up period. New PGA-containing coils show no excess in procedural and periprocedural complications over bare platinum coils, and the recanalization rate is comparable with bare platinum coils in the short term.
Highlights
AND PURPOSE: Endovascular treatment of intracranial aneurysms using platinum coils is effective, but uncommonly aneurysms recur
Data for cases treated with new polyglycolic acid (PGA)-containing coils together with bare platinum coils were analyzed separately
New PGA-containing coils show no excess in procedural and periprocedural complications over bare platinum coils, and the recanalization rate is comparable with bare platinum coils in the short term
Summary
Sixty-seven patients with 68 aneurysms were included in the study. Of these, 51 were treated exclusively with the new polyglycolic acid (PGA)-containing coils, and 17 were treated with a combination of new PGA-containing and other coils. Seventy-two patients with a total of 77 aneurysms were treated using new PGA-containing coils between September 2004 and March 2006. 51 patients (51 aneurysms) were treated exclusively using new PGA-containing coils, and 21 had new PGA-containing coils in conjunction with other types of coils. A single aneurysm in a fenestrated basilar artery was treated with new PGA-containing coils in combination with a Neuroform stent (Boston Scientific, Natick, Mass). This case has been excluded from subsequent analysis, as has a case in which the patient went for surgical clipping immediately postcoiling, resulting in a total of patients with aneurysms being assessed.
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