HydroCoil as an adjuvant to bare platinum coil treatment of 100 cerebral aneurysms.
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.
Fanning
Noel F
NF
Department of Neuroradiology, Beaumont Hospital, Beaumont Road, Dublin, Republic of Ireland.
Berentei
Zsolt
Z
Brennan
Paul R
PR
Thornton
John
J
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
D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D010984:Platinum