Sapphire platinum detachable coil experience in a tertiary-care facility.
BACKGROUND
The Guglielmi Detachable Coil introduced by the Boston Scientific Corporation has been widely used for endovascular coiling of aneurysm. Recently, Sapphire platinum detachable coils (eV3, Irvine, CA) have been introduced for aneurysm coiling. Herein, we report our clinical experience with the Sapphire coil to evaluate the incidence of coil related complications and the rate of aneurysm occlusion.


METHODS
Consecutive patients who underwent embolization with Sapphire detachable coils were prospectively enrolled from January 2004 to September 2004 and the data were retrospectively analyzed. Patient demographics, including age, gender, presenting symptoms, Hunt and Hess grade, Fisher grade and locations of the vascular anomalies were collected. Additionally, complications associated with the coils and rates of aneurysm occlusion were observed and the data compiled.


RESULTS
29 patients underwent Sapphire coil embolization for intracranial aneurysms. Mean age was 50 +/- 18 (mean +/- SD) years with 81% being females. Aneurysm neck reconstruction was required in 7 cases, 6 with Neuroform stent (5 unruptured aneurysms) and 1 with balloon assistance (ruptured aneurysm). In 7 cases, Sapphire coils were used along with other coils. There were no events of thromboembolism or ruptures of aneurysms during coil embolization. However, multi-diameter coils demonstrated stretching in 4 stent-assisted cases without any adverse consequences. Complete occlusion of the aneurysm was achieved in 79.31% of the patients, neck remnant in 6.89, and partial coiling was achieved in 13.79%.


CONCLUSIONS
The Sapphire coil could safely be used in the treatment of both ruptured and unruptured aneurysms. However, multi-diameter non-stretch resistant coils may be associated with coil stretching when used in conjunction with a stent. Further study is still required for definitive results.
Yahia
Abutaher M
AM
Department of Neurology and Neurosurgery, Wayne State University, Detroit, MI, USA. yahia25@hotmail.com
Gordon
Vickie
V
Whapham
John
J
Malek
Ali
A
Rehman
Mohammed
M
Fessler
Richard D
RD
D000328:Adult; D000368:Aged; D000497:Alloys; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D002533:Cerebral Angiography; D016208:Databases, Factual; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D007495:Iridium; D008297:Male; D008875:Middle Aged; D010984:Platinum; D012189:Retrospective Studies
D000497:Alloys; C013616:nitinol; D007495:Iridium; D010984:Platinum
Stroke. 1999 Feb;30(2):470-6
9933290
Neurosurgery. 1995 Oct;37(4):640-7; discussion 647-8
8559291
Stroke. 2002 Oct;33(10):2536-44
12364750
J Neurosurg. 2000 Aug;93(2):175-82
10930001
J Neurosurg. 1998 Jul;89(1):81-6
9647176
Neurosurgery. 1998 Nov;43(5):1016-25
9802844
Stroke. 2001 Mar;32(3):597-605
11239174
Radiology. 1999 May;211(2):325-36
10228510
Ann Neurol. 2000 Jul;48(1):11-9
10894211
AJNR Am J Neuroradiol. 2004 May;25(5):813-8
15140727
Stroke. 2000 Jan;31(1):100-10
10625723
Neurochirurgie. 2005 Sep;51(3-4 Pt 1):155-64
16389901
J Neurosurg. 2000 Oct;93(4):569-80
11014534
J Neurosurg. 1993 Jul;79(1):3-10
8315465
Stroke. 1999 Dec;30(12 ):2617-22
10582987
AJNR Am J Neuroradiol. 2004 Sep;25(8):1368-72
15466334
J Neurosurg. 1999 May;90(5):868-74
10223453
Stroke. 2000 Oct;31(10):2369-77
11022066
Lancet. 2002 Oct 26;360(9342):1267-74
12414200