Endovascular coiling of intracranial aneurysms using bioactive coils: a single-center study.
BACKGROUND
Some degree of recanalization is reported in up to one-third of intracranial aneurysms treated with endovascular coiling. A technical development potentially effective in avoiding recanalization is the Matrix Detachable Coil (MDC), which is covered with a biodegradable polymeric material that enhances intra-aneurysmal clot organization and fibrosis.


OBJECTIVE
To report the initial clinical experience of MDC for endovascular aneurysm coiling in a single-center, single-operator, and well-defined population setting.


METHODS
118 aneurysms in 104 patients (73 with subarachnoid hemorrhage, SAH) were embolized with MDC alone (n = 52) or combined with bare platinum coils (n = 66).


RESULTS
Initial aneurysm obliteration was class 1 (complete obliteration) in 45 aneurysms (38.1%), class 2 (residual neck) in 44 (37.3%), and class 3 (residual aneurysm) in 29 (24.6%). Procedure-related morbidity was 4.8%, and mortality 0.96%. Clinical follow-up of 61 patients with SAH (mean 5.9 months, range 1-17 months) showed good outcome (Glasgow Outcome Scale, GOS 4-5) in 39 (63.9%), and poor outcome or death (GOS 1-3) in 22 (36.1%). Imaging follow-up of 73 aneurysms (average 6.5 months, range 1-17 months) showed class 1 in 47 (64.4%), class 2 in 18 (24.7%), and class 3 in eight (10.9%). Recanalization occurred in 11 aneurysms (15%), of which four (5.5%) required re-treatment.


CONCLUSIONS
This study confirms that aneurysm coiling with MDC is feasible, effective, and safe.
Rossitti
S
S
Department of Neurosurgery, University Hospital, Linköping, Sweden. sandro.rossitti@lio.se
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome