title: Embolization of Cerebral Aneurysms with Spherically Shaped Detachable Microcoils (MicruSphere Microcoil System). A Single Centre Experience.
abstract: We present our initial experience of concentric-filling technique using MicruSphere 3D coils (Micrus Endovascular, San Jose, CA) in the treatment of intracranial aneurysms. 149 intracranial saccular aneurysms in 142 consecutive patients (mean age 56.6-/+12.7, ruptured in 54 (36.2%)) were treated with the concentric-filling technique. The mean aneurysm volume was 169.0-/+363.0 mm(3). Neck remodeling technique was used in 120 (80.5%). Procedure-related problems were recorded. Initial embolization results were evaluated, and the coil packing density was calculated. Clinical and angiographic follow-ups were performed after six months. Any changes in embolization status were classified as 'improved', 'unchanged', or 'worse'. The overall packing density was 40.1% (range 10.5-90.9%). The permanent morbidity and mortality rates were 4.0% and 1.3%, respectively. The initial Raymond and Roy classification results were class 1 in 37 aneurysms (24.8%), class 2 in 50 (33.6%), and class 3 in 62 (41.6%). On the mean follow-up examination of 8.2 months in 103 patients (72.5%), there were one transient ischemic attack, one minor stroke, and one instance of rebleeding. Angiographic follow-up in 101 aneurysms (67.8%) showed the change in embolization status as 'improved' in 42 aneurysms (41.6%), 'unchanged' in 42 (41.6%), and 'worse' in 17 (recanalisation rate, 16.8%). The concentric-filling technique using Micrusphere 3D coils was effective in achieving high packing density which in turn resulted in stable embolization in the majority of the aneurysms. Longer follow-up is warranted to determine the durability of these results.
authors.affiliation: Asan Medical Center, University of Ulsan College of Medicine; Seoul, Korea - dhlee@amc.seoul.kr.
authors.forename: D H
authors.initials: DH
authors.lastname: Lee
authors.forename: A
authors.initials: A
authors.lastname: Arat
authors.forename: H
authors.initials: H
authors.lastname: Morsi
authors.forename: L-D
authors.initials: LD
authors.lastname: Jou
authors.forename: M E
authors.initials: ME
authors.lastname: Mawad
references.citation: AJNR Am J Neuroradiol. 2006 Oct;27(9):1834-40
references.pmid: 17032853
references.citation: AJNR Am J Neuroradiol. 2004 May;25(5):813-8
references.pmid: 15140727
references.citation: Stroke. 2003 Jun;34(6):1398-403
references.pmid: 12775880
references.citation: Surg Neurol. 2006 Dec;66(6):593-601; discussion 601-2
references.pmid: 17145318
references.citation: AJNR Am J Neuroradiol. 2005 Apr;26(4):901-3
references.pmid: 15814941
references.citation: AJNR Am J Neuroradiol. 1995 Jan;16(1):7-13
references.pmid: 7900605
references.citation: J Neuroradiol. 2002 Jun;29(2):114-21
references.pmid: 12297733
references.citation: AJNR Am J Neuroradiol. 2000 Apr;21(4):757-60
references.pmid: 10782791
references.citation: Radiology. 2004 Jun;231(3):653-8
references.pmid: 15118115
references.citation: AJNR Am J Neuroradiol. 2004 Feb;25(2):298-306
references.pmid: 14970036
references.citation: AJNR Am J Neuroradiol. 2005 May;26(5):1223-31
references.pmid: 15891189
references.citation: Acta Neurochir (Wien). 2006 Nov;148(11):1139-45; discussion 1145
references.pmid: 16990989
references.citation: Neurosurgery. 1997 Nov;41(5):1160-5; discussion 1165-8
references.pmid: 9361072
references.citation: J Neurosurg. 2003 May;98(5):959-66
references.pmid: 12744354
references.citation: AJNR Am J Neuroradiol. 2004 Aug;25(7):1147-53
references.pmid: 15313699
references.citation: AJNR Am J Neuroradiol. 2005 Jun-Jul;26(6):1342-8
references.pmid: 15956495
references.citation: AJNR Am J Neuroradiol. 2007 Feb;28(2):387-9
references.pmid: 17297019