title: A single centre study of coil embolization of intracranial aneurysms comparing bare platinum and PGLA-coated coils.
abstract: There is no robust consensus on the efficacy of polyglycolic/polylactic acid (PGLA)-coated coils used in the endovascular embolization of intracranial aneurysms. We present a comparative study of bare platinum coils and PGLA-coated Gugliemi Detachable Coils (GDC) in the treatment of intracranial aneurysms at a single centre, using target aneurysm recurrence and angiographic recanalization as the primary endpoints. We included all patients treated between 1998 and 2009 who had undergone at least one angiographic post-procedural follow-up. Patient demographics, clinical presentation, operative notes, and all relevant imaging were collected. Of the 441 aneurysms with follow-up, 290 were treated with at least one PGLA coil and 151 aneurysms were treated exclusively with bare platinum coils. At follow-up, 26.5% of platinum controls demonstrated angiographic recanalization, compared to 31.4% of PGLA-treated aneurysms (p=0.002). PGLA-treated aneurysms were more likely to have an angiographic remnant at follow-up (odds ratio [OR]=1.96, 95% confidence interval [CI]=1.26-3.04, p=0.003). The post-operative Raymond score was the only predictor of retreatment (OR=1.6, 95% CI=1.08-2.24, p=0.020), and was the second strongest predictor of a complete angiographic result at follow-up (OR=1.67, 95% CI=1.22-2.27, p=0.001). We concluded that PGLA-coated coils demonstrated poorer post-operative and long-term angiographic occlusion in the treatment of intracranial aneurysms, compared to bare platinum coils.
authors.affiliation: Department of Radiology, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: R S
authors.initials: RS
authors.lastname: Bose
authors.forename: R J
authors.initials: RJ
authors.lastname: Dowling
authors.forename: B
authors.initials: B
authors.lastname: Yan
authors.forename: P J
authors.initials: PJ
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000368:Aged; D023181:Antimicrobial Cationic Peptides / Q000008:administration & dosage; D020099:Coated Materials, Biocompatible / Q000008:administration & dosage; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010984:Platinum / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D023181:Antimicrobial Cationic Peptides; D020099:Coated Materials, Biocompatible; C045866:peptide-Gly-Leu-amide; D010984:Platinum