title: Bare platinum vs matrix detachable coils for the endovascular treatment of intracranial aneurysms: a multivariate logistic regression analysis and review of the literature.
abstract: BACKGROUND
  Despite increasing acceptance of endovascular coiling for treating intracranial aneurysms, incomplete occlusion remains a limitation. Attempts to reduce recanalization have prompted creation of polyglycolic/polylactic acid-coated (Matrix) coils shown to improve neointima formation; however, previous publications demonstrate conflicting results regarding their efficacy. Few studies account for factors influencing recurrence, and only 4 studies include bare platinum (BP) coil control groups.
  
  
  OBJECTIVE
  To compare initial and short- and mid-term occlusion as well as retreatment rates using Matrix compared with BP coils.
  
  
  METHODS
  Retrospective review of patients undergoing coiling of cerebral aneurysms from 2001 to 2005 was performed. Analysis included a multivariate logistic regression model designed to detect a 35% absolute difference in initial occlusion between coil treatment groups with 80% power.
  
  
  RESULTS
  Complete initial occlusion was achieved in 64% of BP (n = 45) and 63% of Matrix (n = 56) cases (P = 1.0). Follow-up occlusion rates in the short term and mid term were 52% and 60%, respectively, for BP cases and 42% and 67%, respectively, for Matrix cases (P = .24 and P = .38, respectively). After adjusting for size, morphology, volumetric packing density, location, rupture, and balloon remodeling, no difference in initial and subsequent occlusion or retreatment rates for BP coils versus Matrix coils was appreciated.
  
  
  CONCLUSIONS
  After controlling for factors influencing recanalization, this investigation failed to show a significant difference between coil groups.
authors.affiliation: Division of Interventional Neuroradiology, Department of Neurological Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, New York 10021, USA. Michelle.Smith@uphs.upenn.edu
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Smith
authors.forename: Justin
authors.initials: J
authors.lastname: Mascitelli
authors.forename: Alejandro
authors.initials: A
authors.lastname: Santillan
authors.forename: Jennifer Sousa
authors.initials: JS
authors.lastname: Brennan
authors.forename: A John
authors.initials: AJ
authors.lastname: Tsiouris
authors.forename: Howard A
authors.initials: HA
authors.lastname: Riina
authors.forename: Y Pierre
authors.initials: YP
authors.lastname: Gobin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D020099:Coated Materials, Biocompatible / Q000009:adverse effects; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D019344:Lactic Acid / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010984:Platinum / Q000009:adverse effects; D011100:Polyglycolic Acid / Q000009:adverse effects; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D012086:Reoperation; D012189:Retrospective Studies; D018401:Sample Size; D013525:Surgical Instruments; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020099:Coated Materials, Biocompatible; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D010984:Platinum