title: HydroCoil as an adjuvant to bare platinum coil treatment of 100 cerebral aneurysms.
abstract: BACKGROUND
  The overall safety of the HydroCoil, an expansile hybrid hydrogel-platinum coil, is unknown. We report a prospective observational study of our first 100 cerebral aneurysms treated with HydroCoils, focusing on safety and initial efficacy.
  
  
  METHODS
  Indications, procedural complications, clinical and angiographic outcomes were recorded. Packing density, number of coils deployed and angiographic results were compared with those in a matched control group of 100 aneurysms treated solely with bare platinum coils. HydroCoil complication rates were compared to bare platinum coil rates at our institution and in published series.
  
  
  RESULTS
  Adjuvant HydroCoil treatment led to increased mean percentage aneurysm filling compared to controls (50 +/- 21% versus 27 +/- 13%, P < 0.001). Immediate posttreatment angiographic results showed significantly (P < 0.001) more complete occlusions and fewer incomplete (<95%) occlusions compared to controls. Intermediate follow-up angiograms (median 7.5 months) in 63 aneurysms showed a trend towards fewer incomplete occlusions with HydroCoil treatment. There were significantly fewer major recurrences with HydroCoil treatment compared to the control treatment (9.5% versus 22.6%, P = 0.046). In the adjuvant HydroCoil group, major recurrent aneurysms had significantly less percentage volume packing with HydroCoils than non-recurrent aneurysms (50.3 +/- 5.0% versus 65.3 +/- 18.0%, P = 0.04). There was a 12% procedural complication rate, 6% procedural morbidity and 1% mortality rate, similar to institutional and reported bare platinum coil complication rates.
  
  
  CONCLUSIONS
  HydroCoils can be safely deployed with a similar complication rate to bare platinum coils. They result in improved aneurysm filling. Intermediate follow-up angiography showed significantly fewer major recurrences. Long-term follow-up is required to confirm initial improved stability.
authors.affiliation: Department of Neuroradiology, Beaumont Hospital, Beaumont Road, Dublin, Republic of Ireland.
authors.forename: Noel F
authors.initials: NF
authors.lastname: Fanning
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Berentei
authors.forename: Paul R
authors.initials: PR
authors.lastname: Brennan
authors.forename: John
authors.initials: J
authors.lastname: Thornton
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010984:Platinum; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D010984:Platinum