Treatment of cerebral aneurysms with hydrogel-coated platinum coils (HydroCoil): early single-center experience.
OBJECTIVE
The authors report their experience using HydroCoils in the treatment of cerebral aneurysms.


METHODS
We performed a retrospective review of the first 100 nonrandomized patients (104 coiled saccular cerebral aneurysms) treated with HydroCoils during a 27-month period.


RESULTS
The average percentage of HydroCoil by length detached in treated aneurysms was 45.5% (range, 9.9-100%). Immediate postprocedure angiography demonstrated complete aneurysm occlusion in 34%, neck remnant in 35%, and incomplete occlusion in 32%. Immediate procedure-related morbidity and mortality rates were 5.8% and 0%, respectively. Angiographic follow-up was obtained in 51% (51/100 patients; 53/104 aneurysms; average, 10.3 months; range, 0-31 months). In these 53 angiographically followed aneurysms, the overall recanalization rate was 21%: no recanalization occurred in 23 aneurysms with small size (<10 mm)/small neck (<4 mm) (S/S); 4 recanalizations occurred in 7 aneurysms with small size/wide neck (>4 mm) (S/W); 6 recanalizations (27%) occurred in 22 large (L) aneurysms (>10-25 mm, 70% angiographic follow-up); and 1 giant (G) (>25 mm) aneurysm recanalized. A large proportion of aneurysms that were not initially completely occluded were completely occluded on follow-up (15/43 [35%]). Clinical follow-up was obtained in 73 patients (73%; average, 5.3 months; range, 0-24 months): 93% of these patients were neurologically improved or unchanged. Three patients rehemorrhaged and 3 patients with unruptured aneurysms developed delayed hydrocephalus.


CONCLUSIONS
The overall safety profile of HydroCoils appears acceptable. Preliminary midterm observations suggest less coil compaction/aneurysm recanalization in large aneurysms. However, HydroCoil-related delayed hydrocephalus is a concern.
Berenstein
A
A
Center for Endovascular Surgery, Beth Israel Hyman-Newman Institute for Neurology and Neurosurgery, New York, NY 10019, USA. aberenstein@bethisraelny.org
Song
J K
JK
Niimi
Y
Y
Namba
K
K
Heran
N S
NS
Brisman
J L
JL
Nahoum
M C
MC
Madrid
M
M
Langer
D J
DJ
Kupersmith
M J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D020099:Coated Materials, Biocompatible; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D007223:Infant; D007231:Infant, Newborn; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010984:Platinum; D019736:Prostheses and Implants; D012008:Recurrence; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D010984:Platinum