Neurointervention.  2012 Sep;7(2):85-92. 10.5469/neuroint.2012.7.2.85.

Endovascular Embolization of Intracranial Aneurysms Using Bare Platinum Axium(TM) Detachable Coils: Immediate and Short-Term Follow-up Results from a Multicenter Registry

• Kim BM
• Kim DJ
• Jeon P
• Yoon PH
• Lee BH
• Lee MS
• Lee TH
• Byun JS
• Kim DI

• KMID: 1841094
• DOI: http://doi.org/10.5469/neuroint.2012.7.2.85

Abstract

PURPOSE
Axium(TM) coils were developed to improve the durability of coil-embolized cerebral aneurysms by increasing packing density. The purpose of this prospective multicenter registry was to evaluate the safety and durability of Axium(TM) coils.
MATERIALS AND METHODS
One hundred twenty-six patients with 135 aneurysms of < or = 15 mm in size underwent coil embolization using bare platinum coils, with Axium(TM) coils constituting over 50% of the total coil length. Immediate and short-term follow-up results were prospectively registered and retrospectively evaluated.
RESULTS
Of the 135 aneurysms (83 unruptured and 52 ruptured), immediate post-embolization angiography revealed complete occlusion in 80 aneurysms (59.3%), neck remnants in 47 (34.8%), and incomplete occlusion in 8 (5.9%). The mean packing density was 42.8% (range, 9.5 - 90%) with Axium(TM) coil length constituting a mean of 87.9% of total coil length. The rate of procedure-related complications was 16.3%. Procedure-related permanent morbidity and mortality rates were 3.2% and 0.8%, respectively. Follow-up catheter or MR angiography, which was available in 101 aneurysms at 6 - 15 months (mean, 7.7 months), revealed stable or improved occlusion in 95 aneurysms and worsening in 6 aneurysms (5.9%). Lower packing density (< 30%) remained the only predictor for anatomical worsening on multivariable logistic regression analysis (P < 0.05).
CONCLUSION
In this registry, Axium(TM) coils showed a relatively low rate of anatomical worsening on short-term follow-up imaging with an acceptable periprocedural safety profile compared to reports of other platinum coils. These results may warrant further study of long-term durability with Axium(TM) coils in larger populations.

Keyword

Aneurysm; Coiling; Endovascular treatment

MeSH Terms

Aneurysm
Angiography
Catheters
Follow-Up Studies
Humans
Intracranial Aneurysm
Logistic Models
Neck
Platinum
Prospective Studies
Retrospective Studies
Platinum

Figure

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  Fig. 1 Detachment zone of Axium™ coil. The Axium™ coil rotates and bends in any direction at the detachment zone.

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  Fig. 2 Relationship between aneurysm volume and packing density.vol, volume; txmethod, treatment method

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  Fig. 3 Comparison of aneurysm packing densities according to coiling technique and aneurysm neck type.

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  Fig. 4 Comparison of mean packing densities between the improved/stable group (no recur) and the worsening group (recur) on follow-up imaging study (p < 0.05).

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  Fig. 5 Comparison of aneurysm volume between the improved/stable group and the worsening group on follow-up imaging study (p < 0.05).

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