Polyglycolide/polylactide-coated platinum coils for patients with ruptured and unruptured cerebral aneurysms: a single-center experience
Linfante, Italo ; Akkawi, Nabil M. ; Perlow, Alain ; Andreone, Vincenzo ; Wakhloo, Ajay K.
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Student Authors
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UMass Chan Affiliations
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Keywords
Aged
Aneurysm, Ruptured
Biocompatible Materials
Cerebral Angiography
Cohort Studies
Embolization, Therapeutic
Female
Follow-Up Studies
Humans
Inflammation
Intracranial Aneurysm
Male
Middle Aged
Pilot Projects
Polyesters
Polyglycolic Acid
Polymers
Prospective Studies
Recurrence
Time Factors
Treatment Outcome
Life Sciences
Medicine and Health Sciences
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Abstract
BACKGROUND AND PURPOSE: Recanalization of cerebral aneurysm is a limitation of bare platinum coils (BPCs). In a swine aneurysm model, polyglycolide/polylactide (a polymer)-coated platinum coils (Matrix) accelerated clot fibrosis and reduced recanalization rate and aneurysmal volume. We aimed to evaluate the safety of Matrix coils in patients with intracranial aneurysm. METHODS: This is a single-center, prospective study of patients with intracranial aneurysms treated with Matrix alone or in combination with BPCs. Follow-up evaluation included a 1-month clinical evaluation and a 6- and 12-month clinical and angiographic examination. Primary adverse events included death, stroke, and permanent neurological deficits. RESULTS: Between May 2002 and January 2004, 52 patients (range 34 to 79 years of age; 38 females) were treated for 54 aneurysms (size 7.9+/-4.6 mm; neck 3.9+/-1.5 mm; 26 ruptured). Matrix alone was used in 13 aneurysms. In 39, we used a combination of Matrix and BPCs. Twenty-one aneurysms had a 6-month follow-up examination (11 Matrix; 10 Matrix combined with bare platinum), and 11 completed the 12-month follow-up evaluation (Matrix only). Adverse events not related to the procedure were 2 deaths (ruptured basilar aneurysms) and 1 stroke at day 10 postcoiling secondary to vasospasm. Procedure-related adverse events were 2 strokes. At 6-month follow-up (n=21) evaluation, 2 of 3 recanalizations needed retreatment. At 12-month follow-up (n=11), there was no recanalization in patients treated with Matrix alone and no significant reduction in aneurysmal size. CONCLUSIONS: Polyglycolide/polylactide-coated coils had a satisfactory safety profile. Significant aneurysmal size reduction after coiling was not observed.
Source
Stroke. 2005 Sep;36(9):1948-53. Epub 2005 Jul 28. Link to article on publisher's site