Purpose: We report clinical experience and long-term results in treating 39 AcomA aneurysms in 39 patients using the Penumbra PC400 large volume coil at 13 high volume centers. With its .020” coil size and use of 025” ID microcatheter, the safety and efficacy of the Penumbra Coil 400 (PC400) System in embolization of AcomA aneurysms has not yet been characterized. Methods: Our treatment cohort consisted of 39 aneurysms ranging between 3.5mm and 17mm, treated between March 2012 and May 2014. Six-month follow up were assessed. Data on angiographic results and procedural complications were collected prospectively and analyzed. Results: The mean aneurysm size was 6.2 mm, with 40.8% mean packing density. All aneurysms were treated entirely with PC400 coils, with mean of 5.1 coils placed. Twenty were ruptured and 19 unruptured. Sixty-six percent of the cases achieved an initial Raymond Scale of 1, and 23.7% achieved a Raymond scale of 2. The overall rate of retreatment was 0%, while the rate of morbidity and mortality caused by stroke <30 days was 1.8%. Comparison with a recently published meta-analysis showed similar or superior outcomes with lower procedural complication rates, most notably lower overall vasospasm rate of 6% vs 17% (p=0.023), lower retreatment rate of 0% vs 9% and higher long-term complete and near-complete occlusion of 96% vs 83% with PC400 coils (Tables 1, 2). Conclusion: ACE study data demonstrate that embolization using the PC400 System and 025” ID microcatheter in AcomA aneurysms leads to safe and effective short- and long-term outcomes.
Read full abstract