Ewha Med J.  2012 Mar;35(1):38-43. 10.12771/emj.2012.35.1.38.

Endovascular Treatment of Intracranial Aneurysms Using Polymer Polyglycolic-Lactic Acid Coated Coils

Affiliations
  • 1Department of Neurosurgery, Ewha Womans University School of Medicine, Seoul, Korea. nshsg@ewha.ac.kr

Abstract


OBJECTIVES
In treatment for intracranial aneurysms by coil embolization, recanalization remains the major limitation of coiling, particularly wide-necked or larger aneurysms. The aim of this study was to evaluate technical results and clinical outcome in a single center of consecutive patients with intracranial aneurysms treated with endovascular embolization using polyglycolic-lactic acid (PGLA) coated coils.
METHODS
Between January 2005 and December 2010, 33 patients (male, 8 patients; female, 25 patients; mean age, 57 years) with saccular intracranial aneurysms were treated by means of an endovascular approach using PGLA coated coils. The endovascular procedures and technical outcomes were evaluated. The mean follow-up duration was 15.9 months (range, 6 to 72 months).
RESULTS
Successful embolizations with satisfactory results were achieved in 91%. The degree of occlusion of the treated aneurysm was complete in 23 (69.6%), small neck remnant in 7 (21.2%), and residual filling in 3 (9%). Thirty patients (90.9%) showed no interval change of the residual neck. Three patients (9.1%) demonstrated the recanalization, and 2 of them were successfully recoiled.
CONCLUSION
This preliminary study showed that PGLA coated coils may be safe option and preventable for recanalization in patients with intracranial aneurysms. Further study with more cases, longer follow-up data and well controlled design are required to confirm our results.

Keyword

Endovascular treatment; Intracranial aneurysm; Polyglycolic-lactic acid coated coil

MeSH Terms

Aneurysm
Antimicrobial Cationic Peptides
Endovascular Procedures
Female
Follow-Up Studies
Humans
Intracranial Aneurysm
Neck
Polymers
Antimicrobial Cationic Peptides
Polymers

Reference

1. Butteriss D, Gholkar A, Mitra D, Birchall D, Jayakrishnan V. Single-center experience of cerecyte coils in the treatment of intracranial aneurysms: initial experience and early follow-up results. AJNR Am J Neuroradiol. 2008. 29:53–56.
2. Ding YH, Dai D, Lewis DA, Cloft HJ, Kallmes DF. Angiographic and histologic analysis of experimental aneurysms embolized with platinum coils, Matrix, and HydroCoil. AJNR Am J Neuroradiol. 2005. 26:1757–1763.
3. Gaba RC, Ansari SA, Roy SS, Marden FA, Viana MA, Malisch TW. Embolization of intracranial aneurysms with hydrogel-coated coils versus inert platinum coils: effects on packing density, coil length and quantity, procedure performance, cost, length of hospital stay, and durability of therapy. Stroke. 2006. 37:1443–1450.
4. Geyik S, Yavuz K, Cekirge S, Saatci I. Endovascular treatment of basilar and ICA termination aneurysms: effects of the use of HydroCoils on treatment stability in a subgroup of patients prone to a higher recurrence rate. Neuroradiology. 2007. 49:1015–1021.
5. Ishii A, Murayama Y, Nien YL, Yuki I, Adapon PH, Kim R, et al. Immediate and midterm outcomes of patients with cerebral aneurysms treated with Matrix1 and Matrix2 coils: a comparative analysis based on a single-center experience in 250 consecutive cases. Neurosurgery. 2008. 63:1071–1077.
6. Kang HS, Han MH, Kwon BJ, Kwon OK, Kim SH, Choi SH, et al. Short-term outcome of intracranial aneurysms treated with polyglycolic acid/lactide copolymer-coated coils compared to historical controls treated with bare platinum coils: a single-center experience. AJNR Am J Neuroradiol. 2005. 26:1921–1928.
7. Murayama Y, Vinuela F, Ishii A, Nien YL, Yuki I, Duckwiler G, et al. Initial clinical experience with matrix detachable coils for the treatment of intracranial aneurysms. J Neurosurg. 2006. 105:192–199.
8. Piotin M, Spelle L, Mounayer C, Salles-Rezende MT, Giansante-Abud D, Vanzin-Santos R, et al. Intracranial aneurysms: treatment with bare platinum coils--aneurysm packing, complex coils, and angiographic recurrence. Radiology. 2007. 243:500–508.
9. Raymond J, Roy D, Leblanc P, Roorda S, Janicki C, Normandeau L, et al. Endovascular treatment of intracranial aneurysms with radioactive coils: initial clinical experience. Stroke. 2003. 34:2801–2806.
10. Veznedaroglu E, Koebbe CJ, Siddiqui A, Rosenwasser RH. Initial experience with bioactive cerecyte detachable coils: impact on reducing recurrence rates. Neurosurgery. 2008. 62:799–805.
11. Wong GK, Poon WS. Thromboembolic complications of endovascular aneurysm occlusion using matrix detachable coils. Stroke. 2006. 37:1363.
12. Wong GK, Yu SC, Poon WS. Clinical and angiographic outcome of intracranial aneurysms treated with Matrix detachable coils in Chinese patients. Surg Neurol. 2007. 67:122–126.
13. Ding YH, Dai D, Kadirvel R, Lewis DA, Cloft HJ, Kallmes DF. Relationship between aneurysm volume and histologic healing after coil embolization in elastase-induced aneurysms: a retrospective study. AJNR Am J Neuroradiol. 2008. 29:98–101.
14. Kadirvel R, Dai D, Ding YH, Danielson MA, Lewis DA, Cloft HJ, et al. Endovascular treatment of aneurysms: healing mechanisms in a Swine model are associated with increased expression of matrix metalloproteinases, vascular cell adhesion molecule-1, and vascular endothelial growth factor, and decreased expression of tissue inhibitors of matrix metalloproteinases. AJNR Am J Neuroradiol. 2007. 28:849–856.
15. Killer M, Hauser T, Wenger A, Richling B, Ladurner G. Comparison of experimental aneurysms embolized with second-generation embolic devices and platinum coils. Acta Neurochir (Wien). 2009. 151:497–505.
16. Marjamaa J, Tulamo R, Frösen J, Abo-Ramadan U, Hernesniemi JA, Niemelä MR, et al. Occlusion of neck remnant in experimental rat aneurysms after treatment with platinum- or polyglycolic-polylactic acid-coated coils. Surg Neurol. 2009. 71:458–465.
17. Szikora I, Seifert P, Hanzely Z, Kulcsar Z, Berentei Z, Marosfoi M, et al. Histopathologic evaluation of aneurysms treated with Guglielmi detachable coils or matrix detachable microcoils. AJNR Am J Neuroradiol. 2006. 27:283–288.
18. Bendszus M, Solymosi L. Cerecyte coils in the treatment of intracranial aneurysms: a preliminary clinical study. AJNR Am J Neuroradiol. 2006. 27:2053–2057.
19. Castro E, Villoria F, Castaño C, Romance A, Mendez JC, Barrena R, et al. Spanish registry for embolization of small intracranial aneurysms with cerecyte coils (SPAREC) study: early experience and mid-term follow-up results. Interv Neuroradiol. 2008. 14:375–384.
20. Fiorella D, Albuquerque FC, McDougall CG. Durability of aneurysm embolization with matrix detachable coils. Neurosurgery. 2006. 58:51–59.
21. Geyik S, Ertugrul O, Yavuz K, Geyik P, Saatci I, Cekirge HS. Comparison of bioactive coils and bare platinum coils for treatment of intracranial aneurysms: a matched-pair analysis. J Neurosurg. 2010. 112:709–713.
22. Geyik S, Yavuz K, Ergun O, Koc O, Cekirge S, Saatci I. Endovascular treatment of intracranial aneurysms with bioactive Cerecyte coils: effects on treatment stability. Neuroradiology. 2008. 50:787–793.
23. Leonardi M, Dall'olio M, Vasquez OO, Quercetti C. Preliminary experience of cerecyte coils in the treatment of intracranial aneurysms. Interv Neuroradiol. 2008. 14:285–292.
24. Linfante I, Akkawi NM, Perlow A, Andreone V, Wakhloo AK. Polyglycolide/polylactide-coated platinum coils for patients with ruptured and unruptured cerebral aneurysms: a single-center experience. Stroke. 2005. 36:1948–1953.
25. Linfante I, DeLeo MJ 3rd, Gounis MJ, Brooks CS, Wakhloo AK. Cerecyte versus platinum coils in the treatment of intracranial aneurysms: packing attenuation and clinical and angiographic midterm results. AJNR Am J Neuroradiol. 2009. 30:1496–1501.
26. Pierot L, Bonafe A, Bracard S, Leclerc X. French Matrix Registry Investigators. Endovascular treatment of intracranial aneurysms with matrix detachable coils: immediate posttreatment results from a prospective multicenter registry. AJNR Am J Neuroradiol. 2006. 27:1693–1699.
27. Pierot L, Leclerc X, Bonafe A, Bracard S. French Matrix Registry Investigators. Endovascular treatment of intracranial aneurysms with matrix detachable coils: mid-term anatomic follow-up from a prospective multicenter registry. AJNR Am J Neuroradiol. 2008. 29:57–61.
28. Pierot L, Leclerc X, Bonafe A, Bracard S. French Matrix Registry Investigators. Endovascular treatment of intracranial aneurysms using Matrix coils: short- and mid-term results in ruptured and unruptured aneurysms. Neurosurgery. 2008. 63:850–857.
29. Piotin M, Spelle L, Mounayer C, Loureiros C, Ghorbani A, Moret J. Intracranial aneurysms coiling with matrix: immediate results in 152 patients and midterm anatomic follow-up from 115 patients. Stroke. 2009. 40:321–323.
30. Turk AS, Luty CM, Carr-Brendel V, Polyakov I, Consigny D, Grinde J, et al. Angiographic and histological comparison of canine bifurcation aneurysms treated with first generation matrix and standard GDC coils. Neuroradiology. 2008. 50:57–65.
31. Fanning NF, Berentei Z, Brennan PR, Thornton J. HydroCoil as an adjuvant to bare platinum coil treatment of 100 cerebral aneurysms. Neuroradiology. 2007. 49:139–148.
32. Sluzewski M, van Rooij WJ, Slob MJ, Bescos JO, Slump CH, Wijnalda D. Relation between aneurysm volume, packing, and compaction in 145 cerebral aneurysms treated with coils. Radiology. 2004. 231:653–658.
33. Niimi Y, Song J, Madrid M, Berenstein A. Endosaccular treatment of intracranial aneurysms using matrix coils: early experience and midterm follow-up. Stroke. 2006. 37:1028–1032.
Full Text Links
  • EMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr