Clinical and angiographic outcome of intracranial aneurysms treated with Matrix detachable coils in Chinese patients.
BACKGROUND
Aneurysm recurrence is an innate problem in endovascular treatment of aneurysms with coils. A coated coil system named Matrix (Boston Scientific Neurovascular, Fremont, CA), covered with a bioabsorbable polymeric material (polyglycolide/lactide copolymer [PGLA]), was developed to accelerate intraaneurysmal clot organization and fibrosis. The purpose of this study was to evaluate the efficacy and safety of the Matrix detachable coils in patients with intracranial aneurysms and aneurysmal recurrence rate.


METHODS
In a regional neurosurgical center in Hong Kong, data of patients undergoing endovascular embolization of intracranial aneurysm was collected. In a 20-month period, 42 patients with 44 aneurysms were treated by endovascular embolization using matrix coils alone or mixed with bare platinum coils. Thirty-four patients presented with ruptured aneurysms, and 8 patients presented with unruptured aneurysms.


RESULTS
Twenty-five patients (60%) had 6-month follow-up DSA, and 10 patients (24%) had 18-month follow-up DSA. Seven aneurysm recurrences were identified, amounting to 16% for all aneurysms and 14% for ruptured aneurysms. Four patients were treated by repeated embolization, and 2 patients were treated by microsurgical clipping. Two adverse events due to thromboembolism were noted. One 78-year-old lady with poor-grade subarachnoid hemorrhage treated by partial embolization died from rebleed at day 4. Another patient with partial embolization and spontaneous thrombosis of dorsal wall ICA aneurysm died at 2 months with aneurysm recanalization with rerupture. Twenty-six patients achieved favorable outcome (GOS score 4 or 5) at last follow-up. The aneurysm recurrence rate using bare platinum coils of the same center was 11% and 7% for all aneurysms and ruptured aneurysms, respectively.


CONCLUSIONS
Matrix coil embolization was safe, but there was no reduction in aneurysm recurrence using matrix coils alone or mixed with GDCs, compared with GDCs alone.
Wong
George K C
GK
Division of Neurosurgery, Prince of Wales Hospital, Chinese University of Hong Kong, China.
Yu
Simon C H
SC
Poon
W S
WS
D020341:Absorbable Implants / Q000009:adverse effects; D000328:Adult; D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002681:China; D020099:Coated Materials, Biocompatible / Q000009:adverse effects / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D020767:Intracranial Thrombosis / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D013345:Subarachnoid Hemorrhage; D013525:Surgical Instruments / Q000592:standards / Q000706:statistics & numerical data; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible