title: Safety, immediate and mid-term results of the newer generation of hydrogel coils in the treatment of ruptured aneurysms: a multicenter study.
abstract: OBJECTIVE
  To assess the 'real-world' performance of the newer generation of hydrogel coils in ruptured aneurysms.
  
  
  METHODS
  A multicenter retrospective study was carried out of angiographic and clinical outcome data on consecutive patients with ruptured aneurysms treated with at least 70% of the newer generation of hydrogel coils. Demographics and data on clinical grade, smoking, use of statins, aneurysm size, location, technique used, packing density, immediate angiographic result, angiographic follow-up, rebleeding and clinical outcome were obtained and analyzed.
  
  
  RESULTS
  Eighty patients (54F; 26M) with an average age of 55.1 years were entered in the study. Forty-four presented good clinical grade (Hunt and Hess 1 or 2). Forty-two (52.5%) aneurysms were ≤5 mm. 56.7% of the aneurysms were treated with simple coil embolization and 39.6% with balloon-assisted coil. The packing density ranged from 9.3% to 92.6% (mean 48.5%). Immediate occlusion rates (Raymond-Roy Scale) were: complete occlusion (class I) in 57.5%, residual neck (class II) in 32.5% and residual aneurysm (class III) in 10%. Intraoperative rupture occurred in 3 cases (3.75%). Clinical follow-up, available in 73 patients, showed a good outcome (modified Rankin Scale 0-2) in 76.3%. Preliminary data on imaging follow-up were available in 54 patients (average 6.8 months) with complete occlusion in 77.8%, residual neck in 20.3% and residual aneurysm in 1.9%. There was no re-hemorrhage.
  
  
  CONCLUSIONS
  Our data show that the use of the newer-generation hydrogel coils in the treatment of ruptured aneurysms is feasible, safe and effective with high immediate and mid-term occlusion rates and low morbidity.
authors: Miami Cardiac & Vascular Institute and Baptist Neuroscience Center, Miami, Florida, USA.
authors: Guilherme
authors: G
authors: Dabus
authors: Sutter Health, Sacramento, California, USA.
authors: Lotfi
authors: L
authors: Hacein-Bey
authors: Sutter Health, Sacramento, California, USA.
authors: Bahram
authors: B
authors: Varjavand
authors: Radiology of Huntsville, Huntsville, Alabama, USA.
authors: R Dana
authors: RD
authors: Tomalty
authors: St John Neuroscience Institute, Tulsa, Oklahoma, USA.
authors: Patrick P
authors: PP
authors: Han
authors: St John Neuroscience Institute, Tulsa, Oklahoma, USA.
authors: Vadim
authors: V
authors: Yerokhin
authors: Miami Cardiac & Vascular Institute and Baptist Neuroscience Center, Miami, Florida, USA.
authors: Italo
authors: I
authors: Linfante
authors: Mount Sinai Hospital, New York, New York, USA.
authors: J
authors: J
authors: Mocco
authors: Mount Sinai Hospital, New York, New York, USA.
authors: Thomas
authors: T
authors: Oxley
authors: Medical University of South Carolina, Charleston, South Carolina, USA.
authors: Alejandro
authors: A
authors: Spiotta
authors: Medical University of South Carolina, Charleston, South Carolina, USA.
authors: M Imran
authors: MI
authors: Chaudry
authors: Medical University of South Carolina, Charleston, South Carolina, USA.
authors: Raymond D
authors: RD
authors: Turner
authors: Medical University of South Carolina, Charleston, South Carolina, USA.
authors: Aquilla S
authors: AS
authors: Turk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D020136:Hydrogel, Polyethylene Glycol Dimethacrylate
keywords: Aneurysm; Embolic; Hemorrhage; Subarachnoid